DPR 2012-2013 Supplementary Tables

Table of Contents

1. Details on Transfer Payment Programs Tables
2. Up-Front Multi-Year Funding
3. Greening Government Operations
   • Green Building Targets
   • Greenhouse Gas Emissions Target
   • Surplus Electronic and Electrical Equipment Target
   • Printing Unit Reduction Target
   • Paper Consumption Target
   • Green Meetings Target
   • Green Procurement Targets
4. Horizontal Initiative
5. Internal Audits and Evaluation
6. Respendable Revenue
7. User Fees

Details on Transfer Payment Programs Tables

1. Name of transfer payment program: Contributions for First Nations and Inuit Primary Health Care (Voted)

2. Start date: April 1, 2011

3. End date: Ongoing

4. Description:

The Primary Health Care Authority funds a suite of programs, services and strategies provided primarily to First Nations and Inuit individuals, families, and communities living on-reserve or in Inuit communities. It encompasses health promotion and disease prevention programs to improve health outcomes and reduce health risks; public health protection, including surveillance, to prevent and /or mitigate human health risks associated with communicable diseases and exposure to environmental hazards; and primary care where individuals are provided diagnostic, curative, rehabilitative, supportive, palliative/end-of-life care, and referral services.

(Voted)

5. Strategic outcome(s):

First Nations and Inuit communities and individuals receive health services and benefits that are responsive to their needs so as to improve their health status.

6. Results achieved:

• Improved ongoing access to health promotion/disease prevention programs and services
• Increased community capacity to deliver community-based health promotion and disease prevention programs and services
• Increased community capacity to manage and administer communicable disease control programs
• Increased program and community capacity to address and mitigate environmental public health risks
• Increased appropriate primary care services based on assessed need
• Improved coordinated and seamless responses to primary care needs

16. Comments on variances:

The Planned Spending of $665.3M was increased by $33.0M in approved authorities through Supplementary Estimates A, B & C and increased by $4.9M in transferred authorities from other programs for a Total Authority of $703.2M.

Actual spending was slightly less than anticipated.

17. Audits completed or planned:

• PAAB Audit of Transfer Payment for Public Health Protection: 2013-14
• OAG Audit of Federal Programs for Diabetes: 2012-13
• OAG Audit of Emergency Management on Reserves: 2013-14
• PAAB Audit of the Transfer Payments for FNI Health Promotion & Disease Prevention: 2014-15
• PAAB Audit of Transfer Payments for Home and Community Care: 2014-15

18. Evaluations completed or planned:

• Healthy Child Development: 2009-10
• Healthy Child Development: 2014-15
  
• Mental Wellness: 2012-13
• Mental Wellness: 2015-16
  
• Healthy Living: 2011-12
• Healthy Living: 2014-15
  
• Communicable Disease Control and Management: 2010-11
• Communicable Disease Control and Management: 2014-15
  
• Environmental Health: 2010-11
• Environmental Health: 2016-17
  
• Clinical and Client Care: 2013-14
• Clinical and Client Care: 2017-18
  
• Home and Community Care: 2013-14
• Home and Community Care: 2017-18
  

19. Engagement of applicants and recipients:

Discussed the Terms & Conditions (Ts & Cs) with recipients at the time of renewal of their contribution agreement and as necessary, work with them to ensure they comply with these Ts & Cs.

1. Name of transfer payment program:
Contributions for First Nations and Inuits Supplementary Health Benefits (Voted)

2. Start date: April 1, 2011

3. End date: Ongoing

4. Description:

The Supplementary Health Benefits Program is a national program that provides, to registered First Nations and recognized Inuit in Canada regardless of residency, a limited range of medically necessary health-related goods and services not provided through other private or provincial/ territorial programs. 

The benefits include the following: pharmacy benefits (prescription drugs and some over-the-counter medication), medical supplies and equipment, dental care, vision care, short term crisis intervention mental health counseling, and medical transportation benefits to access medically required health services not available on reserve or in the community of residence.

The Program also pays provincial health premiums on behalf of eligible clients in British Columbia.

(Voted)

5. Strategic outcome(s):

First Nations and Inuit communities and individuals receive health services and benefits that are responsive to their needs so as to improve their health status.

6. Results achieved:

• Improved access to non-insured health benefits appropriate to the unique health needs of First Nations people and Inuit
• Efficient and cost-effective management of access to non-insured health benefits

16. Comments on variances:

The Planned Spending of $165.6M was increased by $32.1M in approved authorities through Supplementary Estimates B and decreased by $0.1M in transferred authorities to other programs, for a Total Authority of $197.6M.

Minimal balance of the variance is due to the fact that Actual Spending was slightly less than anticipated as Supplementary Health Benefits expenditures is a demand driven program.

17. Audits completed or planned:

• PAAB Audit of NIHB Pharmacy: 2011-12
• PAAB Follow-up Audit of NIHB Medical Transportation: 2012-13
• PAAB Audit of FNIHB - Vision Care, Medical Supplies, Mental Health: 2013-14

18. Evaluations completed or planned:

• Supplementary Health Benefits for First Nations and Inuit: 2010-11

• Supplementary Health Benefits for First Nations and Inuit: 2015-16

19. Engagement of applicants and recipients:

Discussed the Ts & Cs with recipients at the time of renewal of their contribution agreement and as necessary, work with them to ensure they comply with these Ts & Cs.

1. Name of transfer payment program:
Contributions for First Nations and Inuit Infrastructure Support (Voted)

2. Start date: April 1, 2011

3. End date: Ongoing

4. Description:

The Health Infrastructure Support Authority underpins the long-term vision of an integrated health system with greater First Nations and Inuit control by enhancing their capacity to design, manage, deliver and evaluate quality health programs and services.  It provides the foundation to support the delivery of programs and services in First Nations communities and for individuals, and to promote innovation and partnerships in health care delivery to better meet the unique health needs of First Nations and Inuit.

The funds are used for: planning and management for the delivery of quality health services; construction and maintenance of health facilities; research activities; encouraging Aboriginal people to pursue health careers; investments in technologies to modernize health services; and integrate and realign the governance of existing health services.

(Voted)

5. Strategic outcome(s):

First Nations and Inuit communities and individuals receive health services and benefits that are responsive to their needs so as to improve their health status.

6. Results achieved:

• Improved quality in the delivery of programs and services
• Provide safe health facilities that support health program delivery
• Promote engagement of key stakeholders in Aboriginal health in the integration of health services
• Improved access to health information

16. Comments on variances:

The Planned -Spending of $244.2Mwas decreasedby $9.5M in approved authorities through Supplementary Estimates B and increased by $29.8M in transferred authorities from other programs, for a Total Authority of $264.5M.

Actual Spending are in line with Total Authorities.

17. Audits completed or planned:

• PAAB Audit of Transfer Payments for FNI Health System Capacity: 2014-15

18. Evaluations completed or planned:

• Health Planning and Quality Management: 2011-12
• Health Planning and Quality Management: 2016-17

• British Columbia Tripartite Initiative 2017-18

• Health Human Resources: 2013-14

• Health Facilities: 2011-12
• Health Facilities: 2016-17

• Systems Integration: 2015-16

• e-Health Infostructure: 2011-12
• e-Health Infostructure: 2016-17

• Nursing Innovation: 2013-14

19. Engagement of applicants and recipients:

Discussed the Ts & Cs with recipients at the time of renewal of their contribution agreement and as necessary, work with them to ensure they comply with these Ts & Cs.

1. Name of transfer payment program:
Contributions in support of the Federal Tobacco Control Strategy (Voted)

2. Start date: April 1, 2001

3. End date:

One phase of the Federal Tobacco Control Strategy program (FTCS) ended in March 31, 2012. However, FTCS was renewed through Budget 2012, including the First Nations and Inuit component.

4. Description:

The purpose of the Federal Tobacco Control Strategy (FTCS) Contribution Program is to contribute to the achievement of FTCS objectives through assistance to provinces, non-governmental organizations, researchers and other tobacco control stakeholders. In 2007, the Government of Canada announced new goals and objectives for the Federal Tobacco Control Strategy until 2011. These are:

Goal:
Reducing the overall smoking prevalence from 19% (2005) to 12% by 2011.

The objectives are to:

• Reduce the prevalence of Canadian youth (15-17) who smoke from 15% to 9%.
• Increase the number of adult Canadians who quit smoking by 1.5 million.
• Reduce the prevalence of Canadians exposed daily to second-hand smoke from 28% to 20%.
• Examine the next generation of tobacco control policy in Canada.
• Contribute to the global implementation of the World Health Organization's Framework Convention on Tobacco Control.
• Monitor and assess contraband tobacco activities and enhance compliance.

5. Strategic Outcome(s):

Canadians are informed of and protected from health risks associated with food, products, substances and environments, and are informed of the benefits of healthy eating.

6. Results Achieved:

With 126 projects funded since 2007, the following results are some highlights:

• National Cessation Guidelines: Development of evidence-based national cessation guidelines.
• Hospital Based Smoking Cessation: Helping recipient organizations implement a systematic approach to the treatment of tobacco dependant patients in hospital based settings.
• Smoking Cessation Counselling: Helping recipient organizations adapt and create tailored cessation programs for specific populations. Population sectors include First Nations and Inuit, pregnant women, persons with mental health issues, and reaching smokers in workplaces.
• Policy and Training: Assisting recipient organizations in exploring new policy options, developing capacity building and training initiatives.
• Social Media: Assisting recipient organizations in exploring the use of social media to deliver cessation programs for young adults.
• First Nations and Inuit: Supporting recipient organizations to tailor and deliver prevention and cessation programs for First Nations and Inuit communities as well as educate and train service providers in tobacco use prevention and cessation.

The Planned -Spending of $15.8M was decreased by $6.6M in approved authorities through Supplementary Estimates and decreased by $7.2M in transferred authorities to other programs, for a Total Authority of $2.0M.

Actual Spending:

In 2012-13, Health Canada's efforts with respect to the renewed Federal Tobacco Control Strategy were focused on the engagement of Aboriginal organizations, and the planning and development of an implementation process. The $2.0M Total Authorities for the First Nations and Inuit component of the Strategy, therefore, was not expended in 2012-13.

17. Audits completed or planned: N/A

18. Evaluations completed or planned:

An evaluation was conducted in 2011-12 and was approved in April 2012. Another evaluation will be conducted in 2016-17.

19. Engagement of applicants and recipients: N/A

1. Name of transfer payment program: Grant for Territorial Health System Sustainability Initiative (THSSI)

2. Start date: April 1, 2010

3. End date: 2014

4. Description:

The Territorial Health System Sustainability Initiative (THSSI) is divided into the following three funds:

• The Territorial Health Access Fund intended to: reduce reliance over time on the health care system; strengthen community level services; and build self-reliant capacity to provide services in-territory. Territorial governments each receive $8.6 million, over two years, to support the implementation of these activities.
• The Operational Secretariat Fund which: supports the functioning of the Federal / Territorial Assistant Deputy Minister's Working Group (F/T ADM Working Group) which oversees the implementation of the THSSI; provides capacity support to territorial governments to administer THSSI; and, supports pan-territorial initiatives that address common territorial health priorities. Territorial governments share $4 million, over two years, to support these activities.
• The Medical Travel Fund which offset the costs of medical transportation in each territory. Nunavut is allotted $20.4 million, NWT $6.4 million and Yukon $3.2 million over the two years of the initiative.

5. Strategic outcome(s):

A health system responsive to the needs of Canadians

6. Results achieved:

The overriding goal of the two-year extended THSSI is to assist the three territories to consolidate progress made under the THSSI in reducing the reliance on outside health care systems and medical travel. For territories, projects that have achieved their goals and were consolidated and integrated with the territorial core business when appropriate.

16. Comments on variances: N/A

17. Audits completed or planned: N/A

18. Evaluations completed or planned: N/A

19. Engagement of applicants and recipients: N/A

1. Name of transfer payment program: Grant to the Canadian Patient Safety Institute (Voted)

2. Start date: December 10, 2003

3. End date: Ongoing

4. Description:

The Canadian Patient Safety Institute (CPSI) is an independent not-for-profit corporation mandated to provide leadership and coordinate the work necessary to build a culture of patient safety and quality improvement throughout the Canadian health system. CPSI promotes leading ideas and best practices, raises awareness and provides advice on effective strategies to improve patient safety.

This grant provided financial assistance to CPSI to help it support implementation of the commitments governments made under the 2003 First Ministers' Accord on Health Care Renewal related to improving health care quality by strengthening system co-ordination and improving national collaboration related to patient safety. CPSI's grant agreement was renewed in 2008 for a five-year period; beginning April 1, 2008 and ended on March 31, 2013 (a new five year contribution agreement was subsequently put in place covering April 1, 2013 to March 31, 2018).

5. Strategic outcome(s):

A health system responsive to the needs of Canadians

6. Results achieved:

To continue to fulfill its mandate, CPSI focused on its strategic priorities of: improving the safety of patient care in Canada through learning, sharing and implementing interventions that are known to reduce avoidable harm; building governance capability; supporting networks; and increasing capacity through evidence-informed resources and tools. For example:

• The Safer Healthcare Now! campaign now has nearly 700 organizations throughout the country implementing evidence-based interventions known to reduce risk for patient harm in areas such as medication reconciliation, infection prevention and control, and surgical safety.
• Over 1,700 participants registered to participate in Canadian Patient Safety Week 2012, a national annual campaign started in 2005 to inspire improvement in patient safety and quality by highlighting patient safety issues, sharing information about best practices, and expanding patient safety and quality initiatives.
• Training was delivered to increase capacity in local organizations through the Effective Governance for Quality and Patient Safety educational program for health care leaders, the Patient Safety Education Project-Canada, and the Canadian Patient Safety Officer Course, and through the opportunities provided to the more than 1,600 sites and 4,200 viewers of Canada's Virtual Forum on Patient Safety and Quality Improvement.
• Targeted patient safety research was funded, including collaborations with partners to support research in the areas of paediatric adverse events and the economics of patient safety in acute care.
• Launched a successful series of weekly essays on health care transformation for Longwoods Publishing, with the theme of "Ghost Busting in Healthcare".
• Continued to support the Global Patient Safety Alerts system, which provide an ongoing resource of actionable information on specific patient safety incidents, and the Improving Care Search Centre, which brings patient safety and quality improvement information together in one easy to access manner.

16. Comments on variances: N/A

17. Audits completed or planned:

The Institute's financial records are reviewed and audited annually by independent external accountants.

18. Evaluations completed or planned:

As per its funding agreement, CPSI conducted an independent evaluation during the 2011-12 Fiscal Year, which was finalized in 2012-13. HC is also conducting a synthesis evaluation involving this program that will be completed in 2013-14.

19. Engagement of applicants and recipients:

To ensure the CPSI funding agreement is managed in an appropriate and efficient manner, Health Canada officials regularly engage with CPSI. In addition, Health Canada appoints one representative to CPSI's Board of Directors, and participates as a Voting Member.

1. Name of transfer payment program: Grant to the Health Council of Canada (Voted)

2. Start date: September 1, 2004

3. End date: June 30, 2014

4. Description:

The Health Council of Canada (the Council) was established by First Ministers in the 2003 Accord on Health Care Renewal with the mandate to report on jurisdictional progress in meeting Accord commitments. The Council's mandate was expanded by First Ministers in the 2004 Health Accord to report on health outcomes and the health status of Canadians. In 2010, the Council's mandate was reconfirmed through Future Directions for the Health Council of Canada by participating federal, provincial and territorial Ministers of Health in their role as Corporate Members of the Council.

5. Strategic outcome(s):

A Health System Responsive to the Needs of Canadians

6. Results achieved:

To continue to fulfill its mandate, the Council undertook a wide variety of projects, released associated public reports and undertook supporting promotional activities. For example, in 2012-13 the Council:

• Released Progress Report 2012: Health Care Renewal in Canada examining progress made in five Accord priority areas (home and community care, health human resources, telehealth, access to care in the North, and comparable health indicators) in consultation with experts, stakeholders and federal, provincial and territorial officials.
• Released the corporate annual report, Health Council of Canada Annual Report 2011-12: Strength in Numbers.
• Developed and released a report concerning seniors and home care entitled, Seniors in need, caregivers in distress: What are the home care priorities for seniors in Canada?
• Developed and released a report on accountability entitled, Measuring and reporting on health system performance in Canada: Opportunities for improvement.
• Developed and released a report on patient self-management entitled, Self-management support for Canadians with chronic health conditions: A focus for primary health care.
• Conducted the National Symposium on Advancing Integrated Health Care in Canada: Practices that Work in October 2012.
• Developed and released a series of video vignettes and primer on clinical practice guidelines entitled, Understanding Clinical Practice Guidelines: A Video Series Primer.
• Developed and released a report on health of Aboriginal people in urban settings entitled, Empathy, dignity and respect: Creating cultural safety for Aboriginal people in urban health care.
• Developed and released a report on results of the 2012 Commonwealth Fund Health Policy Survey entitled, How do Canadian primary care physicians rate the health system?
• Developed and released a report on quality improvement entitled, Which way to quality? Key perspectives on quality improvement in Canadian health care systems.

16. Comments on variance(s):

For 2012-13, up to $8M was allocated for the Council's operating budget. Following approval of its 2012-13 Work Plan and Budget by Corporate Members, the Council requested $6.7M and payments were made accordingly. Also, given that a number of projects from 2011-12 were carried over to the 2012-13 fiscal year; the Council did not use all of the funding provided by Health Canada. The amount of $0.5M not utilized during 2011-12 was deducted from the requested amount for 2012-13 (this is in accordance with the Council's Funding Agreement).

17. Audits completed or planned:

The Council's financial records are reviewed and audited annually by independent external accountants. Audited financial statements can be found on the  Council's website: http://www.healthcouncilcanada.ca.

18. Evaluations completed or planned:

As per the Funding Agreement, the Council submitted a final evaluation framework to the Minister by March 31, 2013, and is required to submit a final evaluation report by March 31, 2014. HC is also conducting a synthesis evaluation involving this program that will be completed in 2013-14.

19. Engagement of applicants and recipients:

The Health Council of Canada engages with participating F/P/T jurisdictions (all, with the exception of Québec), on a regular basis. As Council's Corporate Members, the Ministers of Health of the participating jurisdictions are engaged throughout the planning and implementation of the Council's activities, including the review and approval of the annual work plan and budget. Further, the Council engages with F/P/T officials and consults with them, on an on-going basis, in reviewing and providing comments on project charters, and other materials as appropriate.

1. Name of transfer payment program: Contribution to the Canadian Institute for Health Information (Voted)

2. Start date:

April 1, 1999 (new agreement April 1, 2012)

3. End date: Ongoing

4. Description:

The Canadian Institute for Health Information (CIHI) is an independent, not-for-profit organization supported by federal, provincial and territorial governments that provides essential data and analysis on Canada's health system and the health of Canadians. CIHI was created in 1991 by the F/P/T Ministers of Health to address significant gaps in health information. CIHI's data and its analyses respond to questions about Canada's health systems and assist a variety of stakeholders - funders, policy makers, health system managers, analysts, clinicians and researchers - in making informed decisions.

Since 1999, the federal government has provided funding to CIHI through a series of grants and conditional grants, known as the Roadmap Initiatives. More recently CIHI's funding has been consolidated through the Health Information Initiative, and is currently delivered through a contribution agreement. This combined funding has allowed CIHI to produce quality and timely health information ranging from health care system capacity, wait times data to the development of pan-Canadian health indicators. Most recently, the Health Information Initiative extended funding to CIHI for their 2012-15 Plan: Better data. Better decisions. Healthier Canadians. Under this renewed funding agreement, up to $238.7M is to be delivered to CIHI over three fiscal years (2012-13 to 2014-15).

5. Strategic outcome:

6. Results achieved:

In 2012-13, CIHI continued to make progress in producing more and better data, more relevant and actionable analysis, and improved client understanding and use of CIHI data and information products. The following are selected highlights from the President's Quarterly Reports.

Improving the Comprehensiveness, Quality and Availability of Data
There has been solid progress in data collection, especially surrounding the comprehensiveness and availability of CIHI data holdings. Progress has been made most notably in:

• CIHI has developed a refined vision for health system use of electronic health records and has completed demonstration projects in this area.
• Canadian Multiple Sclerosis Monitoring System (CMSMS):
  • This is a new data holding launched as of September 2012. Test data files will be submitted in early Q1 of 2012-13 from two Canadian clinics.
• Drug Utilization (NPDUIS):
  • British Columbia has submitted test data and live data in March 2013.
  • Newfoundland and Labrador testing claims data in March 2013.
• Medication Incidents (NSIR):
  • There has been progress in data submission capabilities from British Columbia. Live data is expected in 2013-14.
  • More data was submitted from existing facilities especially acute care hospitals in Ontario and long-term care facilities in both Ontario and Manitoba.
• Expanded healthcare financing and funding information by supporting jurisdictions in activity-based funding initiatives and completing the implementation of a patient cost database.
• National Ambulatory Care Reporting System (NACRS):
  • British Columbia facilities are now submitting data.
• Ontario Mental Health Reporting System (OMHRS):
  • Newfoundland and Labrador is submitting partial data.
  • In Manitoba, data submission plans are being developed.
• Joint Replacement (CJRR):
  • Complete data is being received from Ontario. As a result, coverage has now increased from 42 per cent to 77 per cent Canada-wide.
  • British Columbia has also mandated data submission in 2012-13; start date has been staggered across health authorities.
  • Data submission plans are being developed in Manitoba.

In addition, CIHI has improved the timeliness of data holdings. With a few exceptions, the majority of their data is between one and two years old.

Support population health and health system decision-making
Over the last year, CIHI continued to increase the overall depth and breadth of analysis and reporting across all data holdings, developing and releasing 30 analytic products. These included special analytic reports relevant to ongoing priority themes (e.g. access and quality of care, continuity of care, efficiencies and human health resources) and special studies related to priority health services themes (e.g. costs, patient safety). CIHI also developed and released a number of annual reports and other policy-relevant analytic outputs relating to health services, health system performance, health expenditures, pharmaceuticals, and health human resources.

Deliver organizational excellence
Some notable achievements from the last year include:

• The completion of the LEADS pilot (Lead Self, Engage Others, Achieve Results, Develop Coalitions, Systems Transformation).
• Enhancements to the content of the first 3 levels of the CIHI website as well as improved user ability of the web search engine.
• The LEAN principle was applied successfully across the organization to: reduce the eQuery response turnaround time; decrease production time for standardized reports; and removal of internal data management redundancies.
• The Records and Information Management strategy, implementation plan and policy were finalized and approved by senior management.
• All departments continue to develop individual controls as required by International Organization for Standardization (ISO) for the ISO 27001 registration project.

16. Comments on variance(s): N/A

17. Audits completed or planned:

An independent performance audit of the Health Information Initiative (HII) was completed in March 31, 2011. Overall, the audit found that CIHI has designed and implemented practices and processes that promote economy and efficiency. The next planned audit under the new contribution agreement is required by March 31, 2015.

18. Evaluations Completed or Planned:

In June 2013, the Evaluation Directorate released an evaluation of Health Information Initiative activities and performance for years 2007 to 2012. The evaluation confirmed that HII objectives, mandate and activities are aligned and consistent with Health Canada objectives, federal government priorities and the federal role in the development of pan-Canadian health data.

There is a planned evaluation under the new contribution agreement (2012-15) by March 31, 2015.

19. Engagement of applicants and recipients:

None needed. CIHI is the sole recipient of HII funding as per the terms and conditions of the HII, which stipulates that CIHI is the only recipient of HII funding.

1. Name of transfer payment program: Grant to support the Mental Health Commission of Canada (Voted)

2. Start date: April 1, 2008

3. End date: March 31, 2017

4. Description:

As part of Budget 2007, the Government of Canada announced funding for the establishment of a Mental Health Commission of Canada (MHCC), an independent, arm's length organization, designed to focus national attention on mental health issues and to work to improve the health and social outcomes for people living with mental illness. To fulfill its mandate, the Commission has been tasked with:

• developing a National Mental Health Strategy.
• undertaking an anti-stigma campaign to reduce the stigma associated with mental illness.
• building a national Knowledge Exchange Centre to facilitate access to reliable information on mental health and mental illness.

In serving as a national focal point for addressing mental health and mental illness, the
MHCC will undertake a more targeted approach to addressing these issues in Canada; foster improved coordination and information sharing among mental health stakeholders and the public health community; and encourage a better public understanding of mental health and mental illness nationally.

5. Strategic outcome(s):

A health system responsive to the needs of Canadians

Results achieved:

The MHCC has made headway since its inception in 2007, in its ability to build partnerships and bring national awareness to the challenges of mental health and illness. Over the past year, progress has been made on several fronts:

• The release of the first-ever Mental Health Strategy for Canada which builds on the significant work already carried out by the provinces and territories.
• Canada's largest anti-stigma and anti-discrimination initiative, Opening Minds, began replicating best practice programs from its evaluation projects. Over 75 projects are being evaluated or developed into resource material and toolkits across four target groups: healthcare providers, youth, media and the workforce.
• Mental Health First Aid (MHFA), an initiative of the MHCC, has trained approximately 800 instructors in all provinces and territories, which have provided MHFA training to approximately 75,000 Canadians across the country. Adaptations of the MHFA course, including an Adaptation for First Nations, a pan-Territorial Adaptation of MHFA for Northern Life, and an Adaptation of MHFA for Seniors, are all in development and set to be completed between 2013 and 2014.
• The MHCC led the development of a voluntary National Standard for Psychological Health and Safety in the Workplace in partnership with the Bureau de normalisation du Québec (BNQ), and the Consumer Safety Association Group, which was released in January 2013.

16. Comments on variances: N/A

17. Audits completed or planned:

As outlined in the funding agreement, the Commission must engage an independent auditor to conduct a full audit of its financial statements each Fiscal Year. The 2012-13 audited financial statements were presented to the Board of Directors for approval at their June 21, 2013 Board meeting. A copy of the audited financial statements will be provided to Health Canada by July 31, 2013 with the Commission's Annual Report.

18. Evaluations completed or planned:

HC is conducting a synthesis evaluation involving this program that will be completed in 2013-14. A Health Canada led evaluation of the MHCC is also scheduled for FY 2015-16. An Independent Evaluation of the MHCC was also completed in FY 2011-12.

19. Engagement of applicants and recipients:

MHCC is the sole recipient of the grant. Health Canada monitors the recipient's compliance with the funding agreement through the analysis of corporate documents and has regular correspondence with senior management of the organization.

1. Name of transfer payment program: Multi-Year Contribution Agreement for Brain Canada Foundation to establish the Canada Brain Research Fund (Voted)

2. Start date: April 1 2011 (actual funding received Supps C 2012)

3. End date: March 31, 2017

4. Description:

The Canada Brain Research Fund (CBRF) represents a total of up to $200M ($100M from the federal government and $100M from non-governmental donations) in funding over 6 years for cutting-edge brain research. The Fund will be managed by Brain Canada, whose proposed research program is grounded in a transformative approach that looks at the brain as one system and seeks commonalities across what was previously thought of as unrelated diseases. The purpose of the Canada Brain Research Fund research program is to bring together teams of scientists specializing in different disciplines to identify common mechanisms for repair, restructuring, remodeling and recovery of brain functions, and to translate this knowledge into brain repair and recovery that can apply to many different diseases and disorders of the brain and nervous system.

The Canada Brain Research Fund will serve two functions: as a focal point for private investment in brain research, and will attract this investment by matching private donations with Government of Canada funding, and through grants to researchers. The Fund will also support research that advances knowledge of the brain and that promises developments in diagnostics and therapies for Canadians who live with, or will develop neurological disorders.

Through open competition and rigorous Canadian and international peer review, Brain Canada will fund three types of grants aimed at collaboration and accelerating the pace of discovery: (a) transformative multi-investigator grants in brain research; (b) national neuroscience technology platforms; and (c) fellowships to train the next generation of researchers.

5. Strategic outcome(s):

A Health System Responsive to the Needs of Canadians

6. Results achieved:

In the first year of the CBRF, the bulk of Brain Canada's effort was devoted to developing and launching its fundraising campaign and research programs. Two major research competitions were launched: the Multi-investigator Research Initiative (MIRI) team grants and the Research Training Awards. In February 2013, Brain Canada announced the recipients of the first set of training awards, the Bell- Brain Canada Mental Health Research Training Awards.

16. Comments on variances: N/A

17. Audits completed or planned:

While audits have not yet been undertaken, the Agreement provides for audit rights for the Minister. The Agreement provides that the Minister may conduct performance (value-for-money) and compliance audits with respect to the use of funding. The audits would be conducted by Health Canada, in accordance with its Multi-Year Risk-based Departmental Audit Plan.

18. Evaluations completed or planned:

As per the agreement Brain Canada will conduct an Independent Evaluation of the activities of the Canada Brain Research Fund that will measure relevance and performance (effectiveness, efficiency, economy) in achieving immediate, intermediate, and long-term outcomes identified in the evaluation framework. Brain Canada will make the evaluation report available to the Minister no later than September 30, 2016.

19. Engagement of applicants and recipients:

Brain Canada is the sole recipient of the contribution. Health Canada monitors the recipient's compliance with the contribution agreement through the analysis of corporate documents and has regular correspondence with senior management of the organization.

1. Name of transfer payment program: Grant to the Canadian Agency for Drugs and Technologies in Health (Voted)

2. Start date: April 1, 2008

3. End date: Ongoing

4. Description:

The Canadian Agency for Drugs and Technologies in Health (CADTH) is an independent, not-for-profit agency funded by Canadian federal, provincial, and territorial governments to provide credible, impartial and evidence-based information about the cost-effectiveness and optimal use of drugs and other health technologies to Canadian health care decision makers.

5. Strategic outcome(s):

A Health System Responsive to the Needs of Canadians

6. Results achieved:

The purpose of the Named Grant is to provide financial assistance to support CADTH's core business activities, namely, the Common Drug Review (CDR), Health Technology Assessments (HTA) and Optimal Use Projects. Results include: creation and dissemination of evidence-based information that supports informed decisions on the adoption and appropriate utilization of drugs and non-drug technologies, in terms of both effectiveness and cost.

16. Comments on variances: N/A

17. Audits completed or planned:

Audit completed by the Portfolio Audit and Accountability Bureau in November 2012. The objectives of the audit were to determine whether the Strategic Policy Branch (SPB) has put in place an effective management control framework for the oversight and management of the funding agreement; and whether CADTH has complied with the terms and conditions of the funding agreement.

18. Evaluations completed or planned:

In 2011, CADTH underwent a two-phased independent evaluation to determine the performance to date of CADTH's three core activities and other program areas; the current state of CADTH's multi-phase organizational transformation; and the findings to make supporting recommendations to improve the impact of CADTH's customer offerings. HC is also conducting a synthesis evaluation involving this program that will be completed in 2013-14.

19. Engagement of applicants and recipients:

CADTH has produced numerous products and services including health technology reports, optimal use projects, environmental scans, therapeutic reviews and formulary listing recommendations. These deliverables provide guidance and evidence-based information to health care decision-makers regarding the cost-effectiveness and optimal use of health technologies. In particular, the formulary listing recommendations increases transparency across jurisdictions and provides consistency to pharmaceutical reimbursement decisions made by the participating public drug plans.

1. Name of transfer payment program: Drug Treatment Funding Program (Voted)

2. Start date:

October 2007 - Services component
April 2008 - Systems component

3. End date:

March 31, 2013 (Services component)
ongoing (Systems component).

A one year extension of the terms and conditions was received, which now expire March 31, 2014.

4. Description:

Drug Treatment Funding Program (DTFP), under the National Anti-Drug Strategy, provides $111 million in financial support over five years to provincial and territorial governments to support illicit drug treatment services for at-risk youth, and to assist in strengthening the quality of drug treatment services. An additional $10M over five years is designated support for a project in Vancouver's Downtown Eastside.

5. Strategic outcome(s):

Canadians are informed of and protected from health risks associated with food, products, substances and environments, and are informed of the benefits of healthy eating.

6. Results achieved:

DFTP was evaluated in 2012-13 on issues related to relevance and performance. This evaluation found that DTFP demonstrated progress towards all results. In particular, the evaluation concluded that there was evidence that all of the services projects led to either the enhancement of existing services or to the introduction of new services as a result of DTFP funding. Examples of new or enhanced services included: creation of mobile early intervention teams offering services to at-risk youth, placement of outreach workers in new regions within jurisdictions, expansion of outreach services, increasing the number of hours that trained addictions counselors spend in early treatment intervention for youth in high school settings, hiring additional staff and creating inter-professional health teams. Representatives from approximately two-thirds of the services projects indicated their Province or Territory was delivering new services which were not provided prior to DTFP and their focus on horizontal integration and capacity building among front-line workers has led to enhanced service delivery. Additionally, 65% of survey respondents indicated that they believed their project helped at-risk individuals in their region more easily access drug treatment programs. A recent review of project reports found that over 25,000 youth have been reached through various programs, outreach events, drop-in centres and requests for services.

DTFP also made progress in improving treatment systems. The DTFP evaluation found that DTFP had a positive impact on improving collaboration, implementation of evidence-based practices and enhancing evaluation and performance measurement capacity. DTFP encourages multi-jurisdictional and key stakeholder knowledge exchange and collaboration so information can be shared across the country enabling provinces, territories and key stakeholders to work and learn from each other. Sixty-one percent of system and service stakeholders surveyed as part of a national systems project conducted by the Canadian Centre of Substance Abuse reported that collaboration and knowledge exchange were key contributions of their DTFP project to the improvement of substance use services and supports in their jurisdictions. The DTFP evaluation also found evidence of the creation and dissemination of evidence-informed practice information including: literature reviews, research on best practices for intake, concurrent disorders and treatment/withdrawal management, revised policies, procedures, guidelines and standards, training programs and tools in evidence-based decision-making and change management and needs-based planning tools/models. Practice information was disseminated using vehicles such as knowledge exchange websites, web-based networks and knowledge exchange working groups/forums. Over 75% of survey respondents agreed that the DTFP project had either very successfully or somewhat successfully: increased the availability of evidence-informed practice information, made it easier to access evidence-informed practice information and improved the quality of evidence-informed practice information. Individual projects have reported integrating evidence-informed practice information into their treatment systems, program and/or policies as part of their project level evaluation reports. For example, the Tiered Model, which is based on a client-centered evidence-informed approach, has been reflected in provincial addictions and mental health strategies released in Ontario, Alberta and New Brunswick. Nova Scotia and Saskatchewan have also used the Tiered Model as a framework for provincial-level system mapping exercises. Key informants from a Nova Scotia project reported that as a result of DTFP, there has been culture shift and the beginnings of a paradigm change to place more value on the use of evidence.

16. Comments on variance(s):

The DTFP reported authorities are $25.7M. A $1.9M permanent transfer of contributions Vote 10 from Health Canada to Justice Canada was mistakenly recorded in ARLU 2008-09 from DTFP instead of Drug Strategy Community Initiatives Fund (DSCIF).

Prior to 2008-09, DSCIF received $1.9M for a program funded under both Justice Canada and Health Canada called the Drug Treatment Courts (DTC). $1.9M was transferred annually to Justice Canada for the DTCs through an MOU. Since DTC was led by Justice Canada, it was determined following NADS that the Health Canada portion of funds be sent to Justice directly. This was corrected in ARLU 2013-14 and is now a permanent transfer to Justice from Health Canada of $1.9M from DSCIF not DTFP.
The in-year adjustment of $1.9M to DTFP resulted in spending of $27.6M but additional investment of $0.3M was made to support activities in DTFP related to the project "Promoting Evidence-Based System Development" to enhance knowledge exchange activities, increase stakeholder engagement and strengthen the evidence base for the addiction treatment field in Canada.

17. Audits completed or planned:

No audits conducted.

18. Evaluations completed or planned:

An evaluation assessing relevance and performance was conducted in 2012-13. The final report will be approved in 2013-14.

19. Engagement of applicants and recipients:

DTFP continued to engage recipients through various channels. Recipients participated in the Final DTFP Program Evaluation and provided valuable feedback regarding the need for and content of the program. Program consultants worked regularly with recipients to monitor contribution agreements and obtain required performance and evaluation reports. Teleconferences and email contact was used to engage and inform applicants about funding for 2013-14 and continuation of the program.

1. Name of transfer payment program: Drug Strategy Community Initiatives Fund (Voted)

2. Start date: April 2004

3. End date: Ongoing

4. Description:

The Drug Strategy Community Initiatives Fund (DSCIF) will contribute to reducing illicit drug use among Canadians, particularly among vulnerable populations such as youth, by focusing on health promotion and prevention approaches to address drug abuse before it happens. The objectives of the DSCIF are to facilitate the development of local, provincial, territorial, national and community-based solutions to drug use among youth and to promote public awareness of illicit drug use among youth. The Program is nationally delivered.

5. Strategic outcome(s):

Canadians are informed of and protected from health risks associated with food, products, substances and environments, and are informed of the benefits of healthy eating.

6. Results achieved:

An analysis of findings from projects funded under the 2008 call for proposals (CFP) (end date of projects varied with some ongoing up until March 31, 2013) shows that DSCIF projects are showing positive results and that the program is reaching their target population. Over 49,484 youth, 4,435 parents and 626 workers/schools have been reached through 29 DSCIF projects (reach of DSCIF projects will continue to be updated as projects are completed and reports are analyzed). Youth capacity (knowledge and skills) to avoid illicit drug use has been enhanced including the development of leadership skills, communication skills, positive supports/relationships, self-esteem and resiliency. For example, an evaluation of one project in Ontario found that 72.8% of participants agreed they had learned practical skills for handling the pressure to use drugs as a result of the project and a project in British Columbia found a significant change in participant social skills when compared to a comparison group. DSCIF findings have also shown a positive impact on decision-making and behaviours related to youth illicit drug use including helping to resist peer pressure, changes in behaviour intention (i.e. youth believing they would not consume illicit drugs in the future) and changes in actual behaviour (i.e. reduction and/or cessation of drug use). For example, 95% of youth participants in a Saskatchewan project agreed that participating in the project made it less likely they would use drugs.

There is also some evidence to support the finding that DSCIF has led to strengthened community responses to illicit drug issues. Projects focused on the community development side of DSCIF have increased access/availability and uptake of health prevention and promotion knowledge and resources and as a result of their projects, have implemented a number of new services, initiatives or programs. Information is being used in classroom settings, as part of youth workers' daily work and incorporated into strategic plans and community programming. Additionally, some projects have been expanded beyond the original scope of DSCIF and have achieved full or partial sustainability beyond DSCIF funding. Community engagement has also been shown to be an integral aspect of the DSCIF program. In fact, conclusions from case studies completed as part of the DSCIF cluster evaluation found that working collaboratively with existing and new partners appears to be a way of working for DSCIF project.

16. Comments on variance(s):

The DSCIF reported authorities are $11.5M. A $1.9M permanent transfer of contributions Vote 10 from Health Canada to Justice Canada was mistakenly recorded in ARLU 2008-09 from DTFP instead of DSCIF.

Prior to 2008-09, DSCIF received $1.9M for a program funded under both Justice Canada and Health Canada called the Drug Treatment Courts (DTC). $1.9M was transferred annually to Justice Canada for the DTCs through an MOU. Since DTC was led by Justice Canada, it was determined following NADS that the Health Canada portion of funds be sent to Justice directly. This was corrected in ARLU 2013-14 and is now a permanent transfer to Justice from Health Canada of $1.9M from DSCIF not DTFP.

In-year adjustment was made to transfer $1.9M to DSCIF, which should have resulted in spending of $9.6M but additional $0.2M was spent as a result of additional programming undertaken related to the project "Improving Drug Prevention for Canada's Youth", creating the variance of $1.7M.

17. Audits completed or planned:

One audit was completed on a DSCIF project in 2012-13.

18. Evaluations completed or planned:

In 2012-13, the program continued to collect data related to three core program outcomes (awareness of illicit drugs and their negative consequences, capacity (knowledge and skills) to avoid illicit drug use) and community engagement). A report on these outcomes will be completed in November 2013. During 2013-14, an evaluation assessing DSCIF relevance and performance will be completed.

19. Engagement of applicants and recipients:

DSCIF continued to engage recipients through various channels. Recipients participated in the collection of data related to the three core program outcomes and some projects participated in case studies to provide more in-depth information on their outcomes. Program consultants worked regularly with recipients to monitor contribution agreements and obtain required performance and evaluation reports.

1. Name of transfer payment program: Grant to the Canadian Blood Services: Blood Safety and Effectiveness Research and Development (Voted)

2. Start date: April 2000

3. End date: Ongoing

4. Description:

To support basic, applied and clinical research on blood safety and effectiveness issues through the auspices of Canadian Blood Services.

5. Strategic outcome(s):

Canadians are informed of and protected from health risks associated with food, products, substances and environments, and are informed of the benefits of healthy eating.

6. Results achieved:

The program funded research and development activities by Canadian Blood Services that advance medical care in transfusion and cellular therapies for the benefit of Canadian patients. The majority of Project funding was provided to qualified Canadian health researchers, as well as training programs to Canadian university students in the field of blood and transfusion science. CBS also provided operational funding to selected university-based blood research programs in Canada with specific expertise in transfusion medicine.

16. Comments on variance(s): No variances

17. Audits completed or planned: None

18. Evaluations completed or planned:

The department initiated an evaluation of the program in 2012-13. The final report will be tabled in the Fall of 2013.

19. Engagement of applicants and recipients:

• The department gathered information/views from Canadian Blood Services during renewal of the program (i.e. validating program objectives; input on the performance measurement strategy).
• The department convened a knowledge transfer event in January 2013 with Canadian Blood Services for Health Canada personnel with responsibility for federal oversight of blood safety.

1. Name of transfer payment program: Official Languages Health Contribution Program (Voted)

2. Start date: April 1, 2009

3. End date: Ongoing

4. Description:

The Official Languages Health Contribution Program has the following objectives:

• improved access to health services for English-speaking communities in Quebec and French-speaking communities in other provinces and territories.
• increased use of both official languages in the provision of health services in Canada.

These objectives are realized through the following three mutually reinforcing program components:

• The operation of Health Networks to support English and French linguistic minority communities across Canada by enabling linkages between health sector stakeholders to maintain and improve the health services available to these communities.
• Activities for the Training and Retention of Health Professionals to provide an increased supply of health professionals who are able to provide health-related services to English and French linguistic minority communities across Canada.
• Official Languages Health Projects comprising specific time-limited initiatives of one to four years in each province, territory and region that aim to have lasting effects on improving the health services situations for English and French linguistic minority communities across Canada.

5. Strategic outcome(s):

A health system responsive to the needs of Canadians

6. Results achieved:

All funding agreements were concluded as planned.

In 2012-13, 1161 new student registrations were accepted into training programs sponsored through ten post-secondary institutions, as well as the New Brunswick government funded under the coordination of the Consortium national de formation en santé. In the academic year ending in June 2012, there were 632 graduates from these programs across Canada (Nova Scotia - 15, New Brunswick - 168, Ontario - 384, Manitoba - 46, and Alberta - 19). After completion of their programs, graduates are employed in official languages minority communities at a rate of 86%.

McGill University coordinated language training for 1241 health professionals in Quebec in 2012-13 to improve their ability to service English-speaking minority communities. As well, 181 bilingual students completed internships across the regions of Quebec in health and social services occupations, such as speech therapy, occupational therapy and social work.

The 38 health networks that have been established in French and English-speaking minority communities across Canada have also allowed partnerships to be developed and maintained with provincial and territorial governments and key players in the healthcare system to adequately meet the health needs of Official Language Minority Communities (OLMC). For example, in October 2012, with funding from Health Canada, the Réseau Santé en français de Terre-Neuve-et-Labrador developed a Health Passport to facilitate communication between Francophone patients and Anglophone health professionals. This tool, inspired by the Health Passport created by the Megantic English-speaking Community Development Corporation (MCDC), provides a directory of local health resources and a glossary to better understand medical terms in English.

A total of 217 multi-year projects were launched during 2009-13 in English and French-speaking minority communities outside Quebec. In 2012-13, 122 of these projects were concluded. Examples include:

• A "bilingual neighborhood" project launched by the Réseau des services de santé en français de l'Île-du-Prince-Édouard was implemented in a long-term care home that welcomed new residents in January 2013. The home contains 26 beds for residents who speak French and fare better in a bilingual environment. To better serve francophone clients, seven orderly positions were designated bilingual.
• The Réseau santé albertain and Alberta Health Services worked together to identify health professionals who can speak French and are able to offer services to the province's Francophone population, while ensuring that people in need are aware of their presence.

Further information regarding these projects is available from the websites of Program recipients:

• Société Santé en français
• Community Health and Social Services Network
• Consortium national de formation en santé
• McGill University

16. Comments on variance(s): N/A

17. Audits completed or planned: N/A

18. Evaluations completed or planned:

A performance evaluation was completed in March 2013 covering the program activities from 2009 to June 2012. The evaluation found that the program is aligned with the Government of Canada's priorities and with federal roles and responsibilities articulated in Part VII of the Official Languages Act. It noted that the health care needs of official language minority communities differ across Canada, depending on the concentration of the minority population within the majority. While these needs do not appear to differ significantly from the majority population, most members of official language minority communities believe it is important to receive health services in their language. Progress was made in achieving the results related to the training, Health Networks and community projects components. The assessment of efficiency and economy was limited by data gaps. The evaluation pointed to some areas of improvement including: finding cost-effective methods to reach OLMC populations where they are dispersed with a focus not only on training, but also on health professional recruitment and retention; Health Networks working together with post-secondary institutions to help ensure that the offer of training is aligned with identified needs and that internships and permanent positions are available in OLMCs; and enhancing the quality of performance data to enable future evaluations to assess the program impact, efficiency and economy.

19. Engagement of applicants and recipients:

Health Canada holds regular formal and informal consultations with members of OLMCs and frequently communicates with Program recipients. Consultations meetings were held with Société Santé en français in January/March 2013 and Community Health and Social Services Network in December 2012 and February/March 2013. As well, representatives from the Official Language Community Development Bureau and the Department's senior management attended stakeholder meetings and board of directors' meetings of recipient organizations. For example, on December 11, 2012, and February 19, 2013, two Program managers represented Health Canada at a Community Health and Social Services Network advisory committee meeting. In March 2013, a videoconference meeting was held with Program recipients on program renewal under the Roadmap for Canada's Official Languages 2013-18.

1. Name of transfer payment program: Health Care Policy Contribution Program (Voted)

2. Start date: September 24, 2002

3. End date: Ongoing

4. Description:

The Health Care Policy Contribution Program (HCPCP) provides contribution funding for projects that address the challenges facing Canada's health care system. The Program fosters strategic and evidence-based decision-making for quality health care, and promotes innovation through pilot projects, evaluation, research, and policy development on current and emerging health care system issues. The Program has continued to evolve in response to changing health care system priorities and currently consists of three components: the Health Care System Innovation Fund; the Health Human Resource Strategy; and the Internationally Educated Health Professionals Initiative.

The Health Care System Innovation Fund (HCSIF) is designed to be flexible and support projects that address a wide range of health care policy issues to encourage innovation. The Canadian Medication Incident Reporting and Prevention System (CMIRPS) aims to reduce harm caused by preventable medication incidents through activities such as the collection and analysis of standardized incident data and the development and dissemination of information including best practices in support of safer medication use systems.

The goal of the Health Human Resource Strategy (HHRS) is to aid in the establishment and maintenance of a stable and optimal health workforce. Through the HHRS, Health Canada supports provincial and territorial governments, educational institutions and key health-related organizations, to address health human resource issues, such as the distribution of physicians, particularly in underserved locations; effective use of skills; provision of quality health care; and effective planning and forecasting.

By working with the provinces, territories and stakeholder organizations, the Internationally Educated Health Professionals Initiative (IEHPI) is designed to facilitate the integration of internationally educated health professionals by assisting them in obtaining licensure and reducing barriers to practice within the Canadian health care workforce. The IEHPI complements the Pan-Canadian Framework for the Assessment and Recognition of Foreign Qualifications announced by the Forum of Labour Market Ministers in 2009.

5. Strategic outcome(s):

A health system responsive to the needs of Canadians

6. Results achieved:

The Health Care System Innovation Fund directed funding toward research and knowledge transfer activities to support innovation and implementation of best practices in key policy areas such as wait times, care for aging populations, and end-of-life care.

Canadian Medication Incident Reporting and Prevention System (CMIRPS) projects continued to contribute to system level changes to improve the safety of medication use in Canada. For example, through Institute for Safe Medication Practices (ISMP) Canada's individual practitioner incident report analyses, discussions continued with pharmaceutical manufacturers to inform enhancements to labeling and packaging. Over 30 improvements have been made by manufacturers since the inception of CMIRPS and more than 50 recommended system-based safeguards from medication incident analysis learning have been incorporated into Accreditation Canada standards. In addition, the results of CMIRPS analysis and system- based recommendations informed the development of regulatory proposals to modernise the Food and Drug Regulations.

The HHRS and the IEHP Initiative have supported projects which have contributed to: increasing the number of qualified providers entering the health workforce; increasing productivity of health care providers by making full and appropriate use of their skills; and improving access to health care services for all Canadians, particularly in underserved areas. Specific examples include:

• In 2012-13 under the HHRS, 21 innovative projects were funded, with activities such as: improving health human resources planning and forecasting; supporting more effective uses of health provider skills; and, developing learning opportunities to improve the quality of health care.
• In addition, the Family Medicine Residencies Initiative (FMRI), announced in 2011, provided $39.5M in funding to P/Ts with the goal of training approximately 100 family medicine residents in rural and remote areas. A project with the University of Manitoba, which served as a pilot for the FMRI, has resulted in 15 family medicine residents completing their training in underserved rural and remote communities.
• Notable accomplishments through the IEHPI include substantial gains in areas supporting improved integration of internationally educated health professionals, including the development of assessment, bridging, path-finding, orientation, workplace oriented language and communication programs for internationally educated health professionals. In 2012-13, IEHPI funding supported approximately 28 projects, representing all 13 P/Ts and four pan-Canadian organizations.
• Progress has also been made toward pan-Canadian approaches to assessing internationally educated physicians and nurses. For example, IEHPI funding has supported the development and implementation of a common tool to assess an international medical graduate's preparedness for entry into post-graduate training. Partnerships with five of the six assessment centres conducting entry to residency assessments have been developed. In 2012, a total of 931 foreign-trained physicians completed this entry to residency assessment.

16. Comments on variance(s):

Under expenditures are related to delays in receiving approved proposals for funding.

17. Audits completed or planned:

An audit of three contribution agreements with the BC Ministry of Health under the Health Care Policy Contribution Program was completed in 2012-13.

18. Evaluations completed or planned:

The evaluation for the Program was conducted in 2012-13 and the report will be approved in 2013-14. The final evaluation report is expected by September 2013.

19. Engagement of applicants and recipients:

Funding recipients continue to be engaged through site visits, and regular communication regarding the progress of funded projects.

1. Name of transfer payment program: Contribution to the Canadian Partnership Against Cancer (Voted)

2. Start date: April 1, 2007

3. End date: Ongoing

4. Description:

The Canadian Partnership Against Cancer (CPAC) is responsable for implementing the Canadian Strategy for Cancer Control with the following objectives: (1) to reduce the expected number of new cases of cancer among Canadians; (2) to enhance the quality of life of those living with cancer; and (3) to lessen the likelihood of Canadians dying from cancer.

The mandate of the Canadian Partnership Against Cancer Corporation is to provide a leadership role with respect to cancer control in Canada, through the management of knowledge and the coordination of efforts among provinces and territories, cancer experts, stakeholder groups and Aboriginal organizations to champion change and improve health outcomes related to cancer. The CPAC will act as a pan-Canadian resource to provide the most up-to-date knowledge across strategic priority areas including prevention, screening/early detection, patient-centered care, guidelines, standards, as well as supporting key research activities and facilitating the development of a pan-Canadian surveillance system.

5. Strategic outcome(s):

A health system responsive to the needs of Canadians

6. Results achieved:

Since it began operating in April 2007, the CPAC has:

• Armed cancer patients and physicians across Canada with state of the art knowledge about what works best to prevent, diagnose and treat cancer.
• Improved the quality of our national cancer system by monitoring its performance and identifying gaps.
• Provided online cancer training for over 700 medical providers serving more than 215 First Nations communities and organizations with the @YourSide Colleague® Cancer Care Course.
• Improved the quality of life for cancer victims by providing information that addressed their social, emotional and financial needs.
• Implemented a large-scale effort to raise awareness of the common risk factors for cancer and other chronic diseases.
• Initiated the country's largest population health study of risk factors - the Canadian Partnership for Tomorrow Project - which will enroll 300,000 Canadians to explore why some people develop cancer and others do not.
• Expanded cancer screening programs in all provinces and encouraged hard-to-reach populations, such as women living with cervical cancer, to undergo screening - which helped doctors catch cancer earlier.
• Developed programs to help survivors through the tremendous uncertainty following treatment.

16. Comments on variances: N/A

17. Audits completed or planned: N/A

18. Evaluations completed or planned:

An evaluation of CPAC was completed in 2010-11 and another one planned for 2015-16. A performance measurement strategy and evaluation framework have been completed in 2012-13.

19. Engagement of applicants and recipients:

The CPAC works to engage stakeholders through communications activities that include media and online vehicles to both the broader public and the cancer and health communities, and targeted outreach and partnership building. In 2012-13, the CPAC developed a new public engagement and outreach strategy; continued to bring together patients and other key stakeholders through the Canadian Cancer Action Network; began work with a new pan-Canadian Cancer Communications Committee; and released publications addressing issues from breast cancer surgery to cancer system performance.

1. Name of transfer payment program: Assessed Contribution to the Pan-American Health Organization (PAHO)

2. Start date: April 15, 2008

3. End date: March 31, 2013

4. Description:

The Pan American Health Organization (PAHO) is the regional office for the Americas of the World Health Organization (WHO), and functions as the health agency of the Inter-American System and the Organization of American States (OAS). The Organization's purpose is to strengthen national and local health systems, and to improve the health of the people of the Americas, in collaboration with Ministries of Health, other government and international agencies, non-governmental organizations, universities, etc. Canada's assessed contribution allows for full participation as a member of this international organization and to fund Canada's share of the cost of operations of the organization as determined by the governing body, in accordance with its founding treaty and financial rules and regulations. Canada's participation in PAHO furthers the Health Portfolio's broad global health objectives and promotes the following results aimed at: protecting the health of Canadians by enhancing regional health security multilaterally and bilaterally; advancing Canada's influence and interests in the region; and, contributing to the reduction of health disparities leading to greater economic stability to align with Canada's foreign policy objectives for the Americas.

5. Strategic Outcome:

A health system responsive to the needs of Canadians

6. Results achieved:

Canada's membership supports the Government of Canada's Americas Strategy which seeks to strengthen Canada's multilateral and bilateral relationships in the hemisphere within the health sector. In 2012, Canada provided technical assistance thirteen times on health issues such as: regulation of tobacco products, health statistics, human resources for health, implementation of International Health Regulations and control of non-communicable diseases. Further, Canada began a three year term on PAHO's Executive Committee in September 2012, which provides Canada with an opportunity to advance key regional governance and public health priorities. Canada's participation in PAHO Governing Body meeting provides Canada an opportunity to exercise an oversight role in ensuring proper management and administration of the Organisation; to influence decisions and strengthen governance and accountability pertaining to the Organization; and, to work towards greater alignment between PAHO's regional strategies with those of the World Health Organization, ensuring complementary objectives, reporting requirements and outcomes.

The Canada-PAHO Biennial Work Plan (BWP) is a fund of approximately US$400K (2012-13) that is allocated from Canada's assessed contribution and is managed by PAHO. The BWP facilitates policy, regulatory and technical, cooperation in the region, while contributing to improving the health status of citizens in member states, including Canada. Projects supported in 2012-13 touched on the following issues:

• Capacity Building in Mental Health and Substance Use Reduction in the Region and Among Indigenous Peoples
• Strengthening the health sector capacity to detect, treat and prevent intra-family violence as a gender-based cross cutting theme within the broader cooperation of strengthening primary health care and mental health, substance use reduction services.
• Capacity Building in telehealth/telemedicine for remote areas.
• Strengthening national regulatory authorities in selected countries of the hemisphere in pharmaceutical products and medical devices through Health Canada's International Regulatory Forum.
• Strengthening national regulatory authorities in selected countries of the hemisphere in food safety measures.
• Capacity Building in Health Human Resources Planning for Systems Strengthening including policy development, needs-based planning, and in selected countries, strengthening capacity of culturally-competent indigenous health human resources.

Link to  PAHO's website.

16. Comments on variance(s):

Deemed appropriation transfer to the Public Health Agency of Canada for the amount of $460,598 during FY 2012-13. Other variances due to fluctuations in foreign exchange rates.

17. Audits completed or planned:

In the Fall of 2011, the Office of the Auditor General of Canada initiated a performance audit of Government of Canada official development assistance (ODA) spending through multilateral organizations covering fiscal year 2010-11. Canada's assessed contribution to PAHO was reviewed as part of this audit as these resources are reported to Parliament as official development assistance.

18. Evaluations completed or planned:

An evaluation of Canada's assessed contribution to PAHO covering the period 2008-09 to 2012-13 has been undertaken by the PHAC/HC Evaluation Directorate and will be completed in fiscal year 2013-14.

19. Engagement of applicants and recipients:

As a member of PAHO, Canada sits on the Directing Council of the organization as a voting member, thereby influencing the direction of the organization's work as well as the use of its budgets.

Up-Front Multi-Year Funding

1. Name of Recipient: Canada Health Infoway (Infoway)

2. Start date: March 9, 2001

3. End Date: N/A

4. Total Funding:

$2.1B*

*Canada Health Infoway (Infoway) received $1.2B as lump-sum grants between 2001 and 2004. The $400M allocated in 2007 was subject to new conditions - these funds flow to Infoway on an as-needed basis based on cash flow requests.  An additional $500M for Infoway was announced in Budget 2009 and confirmed in Budget 2010. In March 2010, Health Canada and Infoway signed a related funding agreement.  The $500M funds flow to Infoway on an as-needed basis based on cash flow requests.

5. Description:

Canada Health Infoway Inc. (Infoway) is an independent, not-for-profit corporation established in 2001 to accelerate the development of electronic health technologies such as electronic health records, telehealth and public health surveillance systems on a pan-Canadian basis. Its Corporate Members are the 14 federal, provincial and territorial Deputy Ministers of Health.

Since 2001, the Government of Canada has committed the following funding allocations: $500M in 2001 in support of the September 2000 First Ministers' Action Plan for Health System Renewal to strengthen a Canada-wide health infostructure, with the electronic health record (EHR) as a priority; $600M in the First Ministers' Health Accord of February 2003, to accelerate implementation of the EHR and Telehealth; $100M as part of Budget 2004 to support development of a pan-Canadian health surveillance system; and $400M as part of Budget 2007 to support continued work on EHRs and wait times reductions. Also, as announced in Budget 2009 and confirmed in Budget 2010, Canada's Economic Action Plan allocated an additional $500M to Infoway, to support continued implementation of EHRs, implementation of electronic medical records (EMRs) in physicians' offices, and integration of points of service with the EHR system. In March 2010, Health Canada and Infoway signed a related funding agreement, which includes enhanced accountability provisions.

It is anticipated that Infoway's approach, where federal, provincial and territorial governments (F/P/T) participate toward a goal of modernizing electronic health information systems, will reduce costs and improve the quality of health care and patient safety in Canada through coordination of effort, avoidance of duplication and errors, and improved access to patient data.

6. Strategic Outcome(s):

A health system responsive to the needs of Canadians.

7. Summary of Results Achieved by the Recipient:

Investment Strategy: Infoway is a strategic investor, with a funding formula covering up to 100% of territorial and 75% of provincial eligible project development and implementation costs. Infoway provides project oversight and monitoring while provincial/territorial (P/T) partners are responsable for actual system development, implementation and funding of all other costs, including ongoing operational costs. In 2012-13, Infoway approved $12.3 million in new projects (16 projects), bringing its cumulative allocation of investments to $2.098 billion (387 projects since Infoway's inception).

Electronic Health Records (EHRs): Infoway's goal for EHRs, endorsed by all jurisdictions is that by 2016, 100 per cent of Canadians will have an EHR available to their authorized health care professionals. As of March 31, 2013, the core components of an EHR were in place for 55.4% of Canadians.

Results achieved in 2012-13 include:

• Diagnostic Imaging Systems - As of March 2013, an estimated 51,000 health care professionals are using diagnostic imaging system technology. Virtually 100% of exams performed in public hospitals are filmless, stored digitally and available to physicians. Researchers estimate that this has increased productivity by more than 25%, enabling as many as 11 million more exams each year.
• Drug Information Systems - Nearly 35,000 health care professionals are estimated to be using second generation drug information systems that enable authorized care providers to securely view a patient's medication profile online, allow for enhanced medication reconciliation and drug interaction alert checking.
• Registries - Registries needed to identify patients and health care providers have been established in every province. Some work is still required to complete the registries in the territories.
• Laboratory Test Results - Systems to electronically capture and share laboratory tests are now available in most jurisdictions, while others are in various stages of implementation. It is estimated that there are currently over 47,000 users of lab information systems in Canada.
• Clinical reports/immunizations - Most jurisdictions have made clinical reports or immunizations available in a shared repository, while others are at various stages of implementation.

Telehealth: Telehealth is used for a wide range of services, from cancer and stroke care to mental health. Canada has become a global leader in the use of videoconferencing for telehealth and it has one of the largest videoconferencing networks in the world. It is estimated that 97 per cent of hospitals in Canada are telehealth-enabled. In 2012, over 460,000 telehealth events were held across Canada, compared with 350,000 in 2011. These events included remote care for patients, education for health providers and administrative meetings.

Electronic Medical Records (EMRs): Infoway has allocated part of the 2010 federal funding towards investment in EMR systems in community based practices and outpatient settings. On March 31, 2013, Infoway reported that more than 14,000 physicians were enrolled in EMR programs across nine jurisdictions with a physician office program, surpassing the target of 12,000. Furthermore, a First Nations EMR deployment project in Manitoba was completed, covering nine First Nations communities. In addition to EMR deployment in physicians' offices, 20 projects are in progress to implement EMRs in ambulatory care settings that will support approximately 25,000 users.

Early benefits research on EMR investments shows positive demonstrable clinical value, particularly in the area of practice productivity and efficiencies. A recent independent pan-Canadian study commissioned by Infoway reports more than $1.3 billion in benefits of EMRs over a six year period (2006-12). The results of this study are tied to national progress in EMR adoption over the same period, which saw adoption by primary care physicians more than double in Canada from 23% in 2006 to 56% in 2012, based on the surveys of the Commonwealth Fund.

Consumer Health and Clinical Innovation/Adoption: To date, Infoway has invested in nine consumer health and 20 clinical innovation demonstration projects. As of March 31, 2013, 97% of the projects were reporting active clinical/consumer use, with a combined total of more than 21,000 users. These demonstration projects are receiving local, national and international recognition for their innovative nature and the value that they are delivering to patients and care providers.

In 2012-13, Infoway continued its efforts to accelerate the use of electronic health information technologies (IT) by clinicians. Examples of recent initiatives with key stakeholders include:

• Continued support for clinician peer leader networks, now active in eight jurisdictions: these networks have supported more than 300 peer leaders in activities ranging from advice to physicians considering implementing an EMR, to mentoring nurses, pharmacists, physicians and office staff on how to use and integrate technology into clinical practice.
• Launching the "Knowing is Better for Clinicians" campaign: developed by clinicians for clinicians, in collaboration with clinical engagement groups, it includes a series of educational resources such as videos, presentations and articles for use by clinicians who want to share information about the clinical value and progress of electronic health information systems in clinical practice. It is estimated that the campaign resources have reached over 190,000 clinical stakeholders as of March 31, 2013.
• Partnering with physician, nursing and pharmacy educators on programs to prepare future clinicians to practice in a health information technology-enabled environment: during the fiscal year, Infoway worked with national associations of faculties of medicine and pharmacy, and of schools of nursing to establish three projects aimed at strengthening learning on the effective use of health IT.

2018 Pan-Canadian Digital Health Strategic Plan: In 2012-13, Infoway completed   a series of consultations, which involved over 500 stakeholders (including clinicians, consumers, government officials and health care administrators). Stakeholders were asked for their feedback on how digital health solutions could improve the patient experience in the coming years and the value for consumers, clinicians, and governments. These consultations were used to inform a strategic plan for the 2018 horizon. The plan identifies 5 areas of opportunities for advancement (bringing care closer to home, providing easier access, supporting new models of care, improving patient safety, and enabling a high-performing health system), corresponding technologies, and considerations to move forward with the plan.

15. Comments on Variance(s): N/A

16. Significant Evaluation findings by the recipient during the reporting year and future plans:

As per the requirements of the 2010 funding agreement, Infoway submitted in March 2013 an independent performance evaluation conducted to measure how well it has achieved the objectives of the agreement. The evaluation spans the time frame of March 30, 2010 to November 30, 2012.

Overall, the independent performance evaluation was positive, noting that there appears to be consensus among jurisdictional leaders that Infoway is helping to move both national and jurisdictional agendas forward. The report recommended that Infoway continue its current approach. The report also advises Infoway to continue its efforts in the area of benefits evaluation, to show return on investment for its own funding agreements and to provide evidence on the value of the investments being made by jurisdictions and other stakeholders.

17. Significant Audit findings by the recipient during the reporting year and future plan:

As per the requirements of the 2010 funding agreement, Infoway submitted an independent performance audit that encompassed activities under the 2003, 2004, 2007 and 2010 funding agreements. The independent performance audit measured how well Infoway allocated resources to achieve the objectives of all four active funding agreements (e.g., the efficiency and effectiveness with which funding was used).

Overall, the performance audit was positive, noting that Infoway is professional in its operations and quick to respond to opportunities and challenges. The report also noted that Infoway considers efficiency and effectiveness in its activities resulting in tangible benefits to Canadians.

18. Link to recipient's website:

  Canada Health Infoway

1. Name of Recipient: Canadian Foundation for Healthcare Improvement (CFHI), formerly known as the Canadian Health Services Research Foundation (CHSRF)

2. Start date: 1996-97

3. End date: N/A

4. Total Funding:

$151.5M

5. Description:

The Canadian Foundation for Healthcare Improvement (CFHI), formerly known as the Canadian Health Services Research Foundation (CHSRF), is an independent, not-for-profit organization originally established in 1996 to support evidence-informed health services decision-making. Subsequent targeted federal grants in 1999 and 2003 built on this mandate. In total, between 1996 and 2003, CFHI (then known as CHSRF) received $151.5M, starting with an initial federal endowment of $66.5M in 1996. This was followed in 1999 by a grant of $25M to support a ten-year program to develop capacity for research on nursing issues, and a $35M grant to support CHSRF's participation in the Canadian Institutes of Health Research. In 2003, the Government of Canada provided additional funding of $25M to develop a program to equip health system managers and their organizations with the skills to use research to better manage the Canadian health care system over a thirteen-year period.

Building on its history, in 2012 CHSRF's mission and name were changed to the Canadian Foundation for Healthcare Improvement (CFHI) to reflect the evolution of its work.  CFHI remains an independent organization, now dedicated to accelerating healthcare improvement and transformation for Canadians.  It collaborates with governments, policy makers and health system leaders to convert evidence and innovative practices into actionable policies, programs, tools and leadership development.

6. Strategic Outcome(s):

A health system responsive to the needs of Canadians.

7. Summary of Results Achieved by the Recipient:

To fulfill its mandate, CFHI's three strategic priorities guide its healthcare transformation and improvement work: engaging citizens, patients and families; accelerating evidence-informed change/improvement in healthcare delivery; and promoting policy dialogue. All three of CFHI's strategic priorities are propelled by its programs which are focused on realizing change and accelerating healthcare improvement, and enabling improved healthcare efficiency, coordinated care, and patient- and family-centered care. For example, this year CFHI:

• Worked with national organizations, provinces and territories, and public and private organizations to initiate discussions and nurture relationships with healthcare leaders and policy-makers committed to improving healthcare for Canadians, and to support the design, development and delivery of a wide range of initiatives.
• Changed its name, developed new programming, and refocused its existing programs to reflect the evolution of the organization.
• Supported 13 collaborations across the country, representing 181 healthcare leaders, managers and providers to accelerate healthcare improvement. This includes continuation of the Northwest Territories Integrated Chronic Disease Management Strategy, a pan-provincial Northern, Rural and Remote dialogue, and the new Atlantic Healthcare Collaboration for Innovation and Improvement in Chronic Disease.
• Collaborated to train healthcare leaders and managers in Quebec by sharing curriculum and other resources, resulting in 16 new improvement projects in the province to improve healthcare experiences for patients and families, and improve the quality and efficiency of services in Quebec.
• Continued to implement its patient engagement projects across the country to better engage patients in improving healthcare. With 10 of these projects completed, results show improvements such as better communication between providers and patients, better understanding by patients of how health services are organized, and increased efficiency in many areas.
• Supported 24 leaders in completing 17 improvement projects across Canada as part of its Executive Training for Research Application (EXTRA) program, with projects encompassing: change management for improved practice and improved health; leadership and interprofessional collaboration; patient flow and service integration; health system delivery, financing and sustainability; and workforce and work environment data, information technology and knowledge management.
• Organized its annual CEO Forum which was attended by 180 healthcare executives who shared their knowledge about innovative approaches taking place across Canada and internationally in the delivery of care to patients with complex chronic conditions.
• Connected with the healthcare community via its OnCall webinar series, which convened 1300 decision-makers, healthcare providers and researchers to explore a variety of healthcare issues in 6 webinars.
• Supported healthcare policy through the synthesis of evidence and production of papers on healthcare financing, innovation and transformation, in addition to the release of a new suite of Mythbusters articles that use evidence to debunk strongly held erroneous beliefs regarding Canadian healthcare.

15. Comments on Variance(s): N/A

16. Significant Evaluation findings by the recipient during the reporting year and future plans:

As per the requirements of its funding agreement, in 2013 CFHI will begin planning for an independent evaluation, which will be undertaken and finalized in 2014.

17. Significant Audit findings by the recipient during the reporting year and future plan:

CFHI's financial records are reviewed and audited annually by independent external accountants.  The 2012 external financial and pension plan audits showed no major concerns, with the auditors reporting clean audits with no evidence of fraud or illegal acts.

18. Link to recipient's website:

Canadian Foundation for Healthcare Improvement

1. Name of Recipient: Mental Health Commission of Canada -- Conditional Grant to support Research Demonstration Projects in Mental Health and Homelessness

2. Start date: April 1, 2008

3. End date: March 31, 2014

4. Total Funding: $110M

5. Description:

As part of Budget 2008, the federal government provided $110M in funding to the MHCC to support five research demonstration projects in mental health and homelessness over five years (2008-13). Projects are underway in Moncton, Montreal, Toronto, Winnipeg and Vancouver and each site is exploring issues related to various sub-populations. The overall goal of this initiative is to provide evidence about what services and systems could best help people who are living with a mental illness and are homeless.

Expected outcomes:

• the development of a knowledge-base accessible to all jurisdictions that will support more effective policy and program development and more responsive interventions.
• determine appropriate sequencing in the provision of housing supports and the basket of necessary services (e.g. counseling, therapy, drug treatment, circles of support) that support long-term quality of life changes for this population.
• the development of best practices and lessons learned that are applicable to future efforts with respect to mental health and homelessness across Canada, including innovative methodologies for locating, counting and providing targeted interventions to specific subpopulations.
• data that reflects the impact and prevalence of mental health issues and substance abuse challenges among projects; data that reflects any regional and/or subset population distinction and barriers that exist with respect to mental health illness and homelessness.
• identify the unique problems and solutions for diverse ethno-cultural groups within this population.
• support improvements at each project site to address fragmentation through improved system integration and support including on-the-ground information technology solutions.

6. Strategic Outcome(s):

A health system responsive to the needs of Canadians.

7. Summary of Results Achieved by the Recipient:

2011-12 Achievements revised as follows for 2012-13:

• Over the course of the At Home/Chez Soi project, the work of the MHCC and its partners resulted in many important achievements, contributing to improved health and social outcomes for homeless people living with mental illness.
• Participants in the project have benefited from stable housing and supports, experiencing fewer symptoms of mental illness.  There have also been significant reductions in visits to emergency rooms, outpatient clinics and drop-in centers.
• Results and achievements to date are captured in two reports released by the MHCC in the fall of 2012:  the third and final Early Findings Report (http://www.mentalhealthcommission.ca/English/node/5029?terminitial=38) and the Interim Report, which detailed the findings from year 1 of the project (http://www.mentalhealthcommission.ca/English/document/5032/home-interim-report?terminitial=38). 
• Ongoing activities to build awareness and knowledge of Housing First principles, and the At Home/Chez Soi project specifically, continued in 2012-13, including: co-hosting two national think tanks to support continued innovations in housing policy and the development of research papers.  A total of eighteen papers are either in print, in press, or have been submitted to peer-reviewed journals for publication.
• The National Film Board of Canada (NFB) and the MHCC continued to work together on an interactive website which so far contains 20 short documentary films which follow project participants over the period 2011-13.
• The Commission also partnered with the MaRS Centre for Impact Investing and Housing Services Corporation, and the Social Finance for Supportive Housing Working Group, on the development and dissemination of a White Paper and a Toolkit on Social Finance for Supportive Housing.
• The project continues to have international impact as evidenced by a request from Brussels officials to connect with the Montreal At Home/Chez Soi site, and requests for information from the European Commission's Housing First Europe program.
• MHCC has worked with Human Resources and Skills Development Canada, Health Canada and provincial governments to ensure the appropriate transition of At Home/Chez Soi participants to services provided by the provinces.  One-year transition agreements are expected to be in place with all provinces by August 2013.
• MHCC has also worked closely with Human Resources and Skills Development Canada to incorporate findings from At Home/Chez Soi into federal housing policy.  As a result, as detailed in Economic Action Plan 2013, the Government of Canada is investing $119M per year for the next five years in the Homelessness Partnering Strategy using a Housing First approach.

15. Comments on Variance(s):

The full $110M was provided to the recipient upon signing of the agreement in 2008.

16. Significant Evaluation findings by the recipient during the reporting year and future plans:

No evaluation was completed during the reporting year. A Health Canada led evaluation of the MHCC is scheduled for FY 2015-16.  An Independent Evaluation of the MHCC was completed in FY 2011-12, which included the homelessness initiative.

17. Significant Audit findings by the recipient during the reporting year and future plan:

As outlined in the funding agreement, the Commission must engage an independent auditor to conduct a full audit of its financial statements each Fiscal Year. The 2012-13 audited financial statements were presented to the Board of Directors for approval at their June 21, 2013 Board meeting. A copy of the audited financial statements will be provided to Health Canada by July 31, 2013 with the Commission's Annual Report.

18. Link to recipient's website:

www.mentalhealthcommission.ca

1. Name of Recipient: Rick Hansen Man in Motion Foundation

2. Start date: April 1, 2007

3. End date: March 31, 2013

4. Total Funding: $30M

5. Description:

The Rick Hansen Man in Motion Foundation (RHF) is an independent, not-for-profit organization founded by Rick Hansen in 1988 to create solutions to improve the lives of Canadians with spinal cord injury (SCI) and to drive advances in SCI research. Funding is being used to implement the Strategy of the Rick Hansen Institute (RHI), namely to: (1) reduce the incidence and severity of permanent paralysis resulting from SCI; (2) increase the recovery of function following SCI; (3) reduce the incidence and severity of secondary complications associated with SCI; (4) increase the level of satisfaction with quality of life among Canadians with SCI; (5) enhance the customized response to the priority unmet needs of Canadians with SCI; and (6) establish a world class Canadian SCI registry and data management platform.

6. Strategic Outcome(s):

A health system responsive to the needs of Canadians.

7. Summary of Results Achieved by the Recipient:

Key accomplishments of the RHI include:

• The development and expansion of the Rick Hansen Spinal Cord Injury Registry to promote collaborative national research and the collection of longitudinal clinical data of people with traumatic SCI across the health care continuum.
• Partnering with Accreditation Canada to develop comprehensive, evidence-based standards for SCI service delivery in Canada.
• Sponsorship of the ReJoyce (Rehabilitation Joystick for Computerized Exercise) system clinical trial.  ReJoyce is a hand and arm rehabilitation system that is now a commercial product being sold in North America and Europe and waiting approval for sale in Asia.
• Creation and dissemination of "Actionable Nuggets" on best practices in SCI care for family physicians in Canada.
• In 2012-13, the RHF also planned to develop and validate best practices in ER, acute care and rehabilitation, as well as conduct SCI community survey.

15. Comments on Variance(s):

None noted for 2012-13 (the full $30M was provided to the recipient upon signing of the agreement in 2007).

16. Significant Evaluation findings by the recipient during the reporting year and future plans:

A summative performance evaluation for the RHI was received on August 14, 2012. After review, comments and suggestions were sent to the RHF on September 25, 2012. Following-up on those comments, on November 29 2012, the RHF re-submitted a revised report that provided clarification on certain questions, although some methodological and reporting issues were not fully addressed.

Fiscal year 2012-13 was the final year of Health Canada's agreement with the RHF.  A number of the RHF Summative Evaluation report's recommendations are relevant and have been used to inform Western Economic Diversification Canada in their role as stewards of the Budget 2012 funding announcement to the RHF. Relevant recommendations include: 1) the need for increased accountability and reporting; 2) the need to establish an open and transparent process for allocating funds; and 3) the need to better align RHF/RHI mandates and initiatives with the needs of people with spinal cord injury.

17. Significant Audit findings by the recipient during the reporting year and future plan:

As outlined in the funding agreement, the RHI engaged an independent auditor to conduct a full audit of its financial statements each Fiscal Year. The 2011-12 annual audit showed no major concerns. The 2012-13 audited financial statements will be included as part of the RHF Annual (and final) report to Health Canada. The report is scheduled to be submitted by July 31, 2013. 

18. Link to recipient's website:

Rick Hansen Foundation; Rick Hansen Institute

Greening Government Operations

Green Building Targets

Strategies and/or Comments

1. Minimum level of environmental performance: Leadership in Energy and Environmental Design (LEED) New Construction Gold (new construction and build-to-lease projects), Green Globes Design 3 Globes or LEED Core Shell/Commercial Interiors (CS/CI) Silver (major renovation projects valued over $1M).
2. Appropriate threshold (dollar value or floor area): 1000m2, project budget 50%+ value of building replacement cost, significantly affects the building envelope and heating ventilation and air conditioning systems.
3. Applicable building types: temperature controlled office and lab space where benchmark data is available.
4. Rationale for target status: Department is on track to achieve the target, as per departmental strategic framework.

Strategies and/or Comments

1. Minimum level of assessment: BOMA BESt
2. Appropriate threshold (dollar value or floor area): 1000m2
3. Applicable building types: All temperature controlled facilities where Health Canada has full access and control over utilities monitoring and usage.
4. Industry recognized assessment and verification tool used: BOMA BESt
5. Assessment level achieved: BOMA BESt Level 1 for targeted buildings; remaining facilities to be assessed using BOMA BESt tool and may seek certification at the Department's discretion.
6. Targeted buildings where certification sought: Occupational Health Unit, Laboratory Centre for Disease Control Building, and Radiation Protection Building (FY 2013-14).
7. Rationale for target status: Health Canada has assessed 100% of its facilities (6 of 6) as per the departmental strategic framework.  The reduction in the number of facilities is attributed to the closure of Health Canada's custodial laboratory in Winnipeg pursuant to the Government of Canada's Deficit Reduction Action Plan.

Strategies and/or Comments

1. This target is not directly applicable to Health Canada since Public Works and Government Services Canada (PWGSC) negotiates leases on behalf of the Health Canada. As the client, Health Canada can only request inclusion of this target in its lease requirements and adherence to FSDS green building targets pursuant to PWGSC's Strategic Framework and Departmental Sustainable Development Strategy.

Strategies and/or Comments

1. Minimum level of environmental performance: Green Globes Design 3 Globes or LEED CI Silver.
2. Appropriate threshold (dollar value or floor area): $1M and 1000m2.
3. Applicable building types: temperature controlled facilities where Health Canada has full access and control over utilities monitoring and usage.
4. Rationale for target status: Three projects completed by Health Canada under its National Accommodation Strategy have achieved a rating of 3 Globes under the Green Globes Design criteria using the online assessment tool.

Greenhouse Gas Emissions Target

Strategies and/or Comments

1. Scope: Targeted GHG emissions sources include only on-road fleet operations.
2. Tools and Resources: The Fleet GHG Inventory Accounting Template provided by PWGSC and the Automotive Resources International database is used to monitor and manage fleet operations.
3. Implementation Plan to reduce GHG emissions includes:

   Interim target: Health Canada's annual interim target is 1% absolute reduction in GHG emissions annually until 2020-21, relative to baseline 2005-06.

   Key activities include: Replacement of old vehicles; policy adherence; and communications to raise employee awareness.

4. In 2012-13, GHG emissions decreased by 16% from the baseline year (2005-06) exceeding our 2021 target. In 2011-12, GHG emissions decreased by 20% from 2005-06. The variance in results from last year is due to an increase in the purchase of diesel fuel (49%) and a decrease in the purchase of ethanol blended fuel/E85 (43%).
5. Roles and responsibilities: Director of Materiel and Assets Management is overseeing this target. Input and support comes from Health Canada fleet managers and cost centre managers.

Surplus Electronic and Electrical Equipment Target

Strategies and/or Comments

1. Definition of location: Health Canada has defined location as a region, of which there are nine (9); National Capital Region (NCR); Atlantic; Quebec; Ontario; Manitoba; Saskatchewan; Alberta; British Colombia; and the Northern region.
2. Standard Operating Procedures for the Management of Surplus EEE have been developed to meet the needs of both Health Canada and the Public Health Agency of Canada at all locations across the country.  Formal approval of the procedures has been delayed due to internal services adjustments to internal services however approval and subsequent implementation is anticipated at all locations by 2013-14.
3. Rationale for target status: Health Canada is on track to achieve 100% of locations with an EEE implementation plan fully implemented.
4. Adjustments: None.

Printing Unit Reduction Target

Strategies and/or Comments

1. Definition: desktop printers, network printers and multi-functional devices.
2. Scope: all employees and devices with the exception of those exempted under the Health Canada Printing Unit Policy for confidentiality, isolated locations, duty to accommodate or connection to specialized equipment.
3. Method used for determining the number of printing units: Network printing units have been determined utilizing OpenView; a network discovery service. Personal printing units were determined by a walk-thorough exercise and analysis of asset management databases and tools.  Branch managers validated the data from the walkthrough exercise as part of their efforts to achieve ratios.
4. Method used for determining number of employees: Number of occupied workstations taken from the CAFM accommodations management database.
5. Number of employees subject to this target: 11,458.
6. Rationale for target status: Through the Health Canada Printer Reduction Strategy, the department was able to reduce the number of its shared network printers by 1,566.
7. Roles and responsibilities: ADM of Corporate Services is the target lead.  Branch ADMs are responsable for meeting the 8:1 ratio within their respective work units.

Paper Consumption Target

Strategies and/or Comments

1. Scope: Health Canada elected to include all departmental employees, instead of just office employees.
2. Method used for determining paper consumption: PWGSC standing offer data usage.
3. Method used for determining number of employees: Number of occupied workstations taken from the Computer Automated Facilities Management accommodations management database.
4. Number of employees subject to this target: 11,458.
5. Rationale for target status: Health Canada has already reduced paper consumption by 40%, and exceeded the 2013-14 target of 20%. Health Canada will sustain efforts to reduce further.
6. Roles and responsibilities: ADM of Corporate Services Branch is the target lead.

Green Meetings Target

Strategies and/or Comments

1. Scope: All meetings held at Health Canada offices.
2. Rationale for target status:  Health Canada has adopted a green meeting guide.

Green Procurement Targets

8.10 As of April 1, 2011, each department will establish at least three SMART green procurement targets to reduce environmental impacts.

Strategies and/or Comments

1. Scope:
   • N7010 Automatic Data Processing (ADP) equipment
   • N7020 ADP CPU
   • N7021 ADP CPU
   • N7022 ADP CPU
   • N7025 ADP Input-Output
   • N7035 ADP Support Equipment
   • N7042 Mini and Micro Computer Control Devices
2. Exclusions: laboratory or field equipment and purchases using acquisition cards.
3. Departmental policy mandates the use of PWGSC standing offers (which include IT hardware purchases).
4. Percentage of "unknown" responses from the baseline year decreased from 34.7% to 6.29% in 2012-13.
5. Health Canada increased the percentage of IT hardware purchases with environmental features by 4% in 2012-13; from 88% in 2011-12, to 92% in 2012-13.
6. Health Canada exceeded the self-selected target of 60% by 32% in 2012-13.
7. Health Canada continues to use its green procurement field in SAP to assess the environmental friendliness of IT hardware.

Strategies and/or Comments

1. Scope:
   • N7045 Computer supplies and accessories
   • N7510 Office supplies
   • N7520 Office devices and accessories
   • N7530 Stationery and record forms
   • N7540 Standard forms
   • N9905 Signs and identification plates
2. Exclusions: Purchases using acquisition cards
3. Health Canada continues to use its green procurement field in SAP to identify office supplies with environmental features.
4. The percentage of "unknown" responses from 2011-12 has decreased from 40% to 29% in 2012-13.
5. In 2012-13, Health Canada exceeded the baseline of 30% in 2009-10 by 23% and is on track to achieve the self-selected target of 60%.
6. A communications strategy was developed to encourage cost centre administrators and/or procurement specialists to purchase green office supplies and to use the green procurement field in SAP.

Strategies and/or Comments

1. Annual reports were obtained through SAP and/or Automotive Resources International to identify new fleet acquisitions. These were individually assessed against the existing fleet standard matrices to determine compliance.
2. Heath Canada implemented the communications strategy, as developed in 2011-12, and which supported increased compliance with the Health Canada Fleet Standard.
3. A baseline of 45% had been determined and in 2011-12, 48% of vehicles purchased were right-size for operational needs.
4. For 2012-13, 64% of vehicles purchased were right-sized for operational needs which represents an increase of 16% from 2011-12. In 2012-13, of the 45 fleet purchases, 29 were compliant with Health Canada's Fleet Standard.

8.11 As of April 1, 2011, each department will establish SMART targets for training, employee performance evaluations, and management processes and controls, as they pertain to procurement decision making.

Strategies and/or Comments

1. The Green Procurement Policy supports all designated employees (PG group) to take green procurement training.
2. In 2012-13, the Materiel and Assets Management Division (MAMD) went through a major transformation initiative including the consolidation of 10 procurement offices from across Canada. A first assessment of individual's learning needs was conducted and a plan is in place to ensure achievement of target by March 31, 2014.
3. As of April 1, 2013, 24 out of 31 designated employees have completed the green procurement training course (C215).
4. As of April 1, 2013, 7 designated employees are scheduled to complete the green procurement training course (C215).
5. Health Canada is on track to achieve its departmental training target of 100% by March 31, 2014.

Strategies and/or Comments

1. Phase 1a: By April 1, 2012, all Health Canada materiel and asset management managers and functional heads within the Materiel and Assets Management Division (MAMD) had GGO clauses embedded into their employee performance evaluations.
2. Phase 1b: By April 1, 2012, Health Canada included an environmental consideration measure in executive performance agreements but was later modified to reflect new Budget 2012 priorities. By April 1, 2013, Health Canada adopted a more strategic approach to performance management agreements by linking performance expectations to departmental plans and priorities.
3. Phase 2: During 2011-12, Health Canada completed the assessment of the scope of program and regional managers [Regional Senior Financial Officers and Fleet Managers] with procurement responsibilities/authorities related to GGO. In 2012-13, MAMD went through a major transformation initiative including the consolidation of 10 procurement offices from across Canada. Regional Senior Financial Officers are no longer responsable for procurement activities. By April 1, 2013, Health Canada adopted a more strategic approach to performance management agreements by linking performance expectations to departmental plans and priorities.

Strategies and/or Comments

1. In 2012-13, the Materiel and Assets Management Division went through a major transformation initiative including the consolidation of 10 procurement offices from across Canada, as well as Budget 2012 decisions. As a result, governance, policies, processes, procedures, as well as tools and templates are currently being revised and will be completed by March 31, 2014.

Horizontal Initiative

1. Name of horizontal initiative: Federal Tobacco Control Strategy (FTCS)

2. Name of lead department(s):

Health Canada

3. Lead department PAA Program:

Substance Use and Abuse

4. Start date: April 2012

5. End date: March 31, 2017

6. Total federal funding allocation (start to end date): $230.4 M

7. Description of the horizontal initiative (including funding agreement):

The Federal Tobacco Control Strategy was initiated in 2001. In 2012, the Strategy was renewed for five years to provide a focused federal presence to preserve the gains of the past decade and continue the downward trend in smoking prevalence. The renewed strategy focuses on the core areas of federal responsibility and invests in new priorities including populations with higher smoking rates.

8. Shared outcome(s):

To preserve the gains made over the past decade, and to continue the downward trend in smoking prevalence.

9. Governance structure(s):

Health Canada remains the lead department with responsibility for the coordination and implementation of the FTCS.  As part of the Health Portfolio, the Public Health Agency of Canada will deliver a contribution program that will fund tobacco-related interventions that aim to reduce tobacco use as a chronic disease risk factor.

Federal partners manage the control of tobacco products through monitoring and assessing the illicit and licit tobacco markets.

• Public Safety Canada - monitors contraband tobacco activity and related crime.
• The Royal Canadian Mounted Police - works with federal partners to identify and investigate criminal activities and to coordinate information on national and international contraband tobacco issues.
• The Canada Border Services Agency - increases knowledge of contraband domestically and internationally by liaising with tobacco authorities at all levels and by monitoring and providing regular reports on both national and global contraband tobacco. The CBSA provides reports, information and guidance to the Department of Finance Canada on matters that will impact the future tax structure of tobacco.
• The Canada Revenue Agency - administers the Excise Act 2001, which governs federal taxation of tobacco products and regulates activities involving the manufacture, possession and sale of tobacco products in Canada.
• Public Prosecutions Service Canada - monitors federal fines imposed in relation to tobacco and other types of offences in order to enforce and recover outstanding fines. FTCS funding for the ODPP ended 2012-13.

10. Performance highlights:

Few other countries have been as successful as Canada in lowering smoking rates and shifting public attitudes about tobacco. Smoking prevalence is now at its lowest-ever overall rate. As of 2011, 17% of Canadians were current smokers, down from 22% in 2001. Further, 8% of teens aged 15-17 are current smokers. Working in its core area of responsibility, and building on past activities, the federal government has refocused the 2012-17 Strategy to concentrate on two groups with higher rates of smoking than most Canadians - on-reserve First Nations and Inuit people and young adults - as well as tobacco as a risk factor for serious disease.

Notes:

17.1
The Health Portfolio will achieve results in the following areas:

Regulations and Compliance - Identifying and developing regulatory proposals under the Tobacco Act and the Contraventions Act, and amending existing regulations as necessary. Conducting compliance monitoring activities and undertake enforcement measures with respect to the Tobacco Act and its regulations.

Research - Conducting research and surveillance to support decision making and the development of anti-tobacco policies and programs.

Policy - Monitoring, coordination and policy support to respond to key emerging and international issues. Leadership in stakeholder engagement with organizations such as the Canadian Coalition on Tobacco Control and the F/P/T Tobacco Control Liaison Committee. Working with national and international partners to ensure Canada meets its obligations under the World Health Organization Framework Convention on Tobacco Control.

Litigation - Providing base funding for ongoing or any new tobacco litigation and for the defense of the Tobacco Act and its regulations.

Community interventions - Supporting interventions and programming that aim to reduce tobacco use, and supporting on-reserve First nations and Inuit communities to implement evidence-based tobacco control strategies. Providing funding to provinces and territories to support increases in quitline service utilization.

17.2
Enhanced partnership arrangement with Akwesasne Mohawk Police through the administration of contribution funding for monitoring activities in connection with determining levels of contraband activity.

Leading interdepartmental efforts to explore the implementation of the Protocol to Eliminate the Illicit Trade in Tobacco Products under the World Health Organization Framework Convention on Tobacco Control.

Provide policy leadership and development of strategies to support law enforcements efforts to combat organized crime in the trade of contraband tobacco.

17.3
RCMP Police Operations (Tech Ops): Improve border security through the use of sophisticated technology which permits detection and monitoring of illegal border intrusions, resulting in vital intelligence in support of criminal intelligence.

RCMP Canadian Law Enforcement Services (CI): Provide regular reports on the illicit tobacco situation to Finance and Health Canada, including data on seizures, organized crime involvement and trends. Side bar reports and presentations to other partners and key Ministerial entities upon request, such as the Governement of Canada Task Force on illicit Tobacco, the Senior Revenue Officials Conference and the Interprovincial Investigations Conference (IIC).

Attend regular meetings to brief the Department of Finance and other agencies on the illicit tobacco market.

Participate in information sharing sessions with American Law Enforcement partners. Give presentations at law enforcement courses/workshops in Canada and the U.S. on the subject of contraband tobacco.

17.4
Provide advice to Department of Finance on matters that will impact the future tax structure on tobacco.

Monitor and report on the contraband tobacco situation in Canada.

Expand cooperation with international and national law enforcement partners.

Collection of the tobacco duties imposed on personal importations of returning Canadians.

17.5
Legislative Policy and Regulatory Affairs Branch:

• Verify Export Activity.
• Ensure compliance with legislative requirements imposed on the manufacture, possession and sale of tobacco products in Canada.
• Work with stakeholders to monitor and assess the effectiveness of measures used to reduce contraband tobacco.
• Support RCMP/CBSA enforcement activities.

Assessment and Benefit Services Branch:

• Maintaining accounts, provide services relative to account transactions (including refunds) and produce reports of tobacco-related activities.

17.6
Increase the number of fines satisfied by a minimum of 18 percent.

Increase registration of outstanding fines in CRA's income tax/GST/HST set-off program by 20%.

Prioritize payment of fines over incarceration, but enhance enforcement measures when appropriate.

Continue to prioritize the most effective and least costly recovery methods.

18.1
The Federal Tobacco Control Strategy (FTCS) was renewed through Budget 2012.

As part of a renewed strategy, Health Canada implemented a new compliance and enforcement regime for the Tobacco Products Labelling Regulations (Cigarettes and Little Cigars), that covered tobacco manufacturers, importers and retailers.  New Health Warning Messages, which include the Pan-Canadian Quitline number and web portal, began appearing on cigarette and little cigar packages in early 2012.  Health Canada provided funding to the Provinces and Territories to support the implementation of the Pan-Canadian Quitline number and web portal.

During 2012, Health Canada wound down its retail inspections relating to tobacco sales to youth, and terminated its Memoranda of Agreement on tobacco compliance and enforcement that the department had with six provinces.

The department released the results of the Youth Smoking Survey (YSS) in May 2102 and the Canadian Tobacco Use Monitoring Survey (CTUMS) in September 2012. In 2012-13, Health Canada developed and launched the new Canadian Tobacco Alcohol and Drugs Survey (CTADS).  This biennial survey will replace CTUMS and the Canadian Alcohol and Drug Use Monitoring Survey (CADUMS).

Health Canada also supported the successful defence of Canada in the $57B Blais and Létourneau class actions. This included the identification and collection of a large number of tobacco related documents in the care and possession of the department as part of one of the largest discovery processes in Government of Canada's history.

Health Canada oversaw international obligations relating to tobacco control and fulfilled reporting requirements under international conventions. In November 2012, Health Canada led the Canadian delegation to the 5th session of the Conference of the Parties (COP) as part of Canada's commitments to the World Health Organization Framework Convention on Tobacco Control.

Health Canada supported engagement of internal and external stakeholders and provided secretariat support to the Federal/Provincial/Territorial Tobacco Control Liaison Committee. In 2012-13, it distributed over 94,000 publications and responded to over 1,300 public enquiries on tobacco issues.

18.2
Managed Akwesasne Mohawk Initiative (API) contribution agreement to support Akwesasne Mohawk Police Service in combating organized crime in and around Akwesasne Mohawk Territory.

Led Canadian delegation to fifth session of the Intergovernmental Negotiating Body in April 2012, where negotiations for a Protocol to Eliminate the Illicit Trade in Tobacco Products were finalized. PS is leading interdepartmental efforts to explore the signature and implementation of the Protocol.

Commissioned a research project to develop a tool to estimate the size of the contraband tobacco market in Canada, intended to inform the development of policy to address the contraband tobacco market.

18.3
RCMP Technical Operations provided ongoing support through the use of sophisticated technology that improved border security by detecting illegal border intrusions to monitor the movement of people, vehicles, shipping containers and other packages, resulting in vital intelligence for pattern analysis on illicit activities. Such technologies act as a force multiplier as intrusions are registered automatically in electronic format, suitable for analysis to establish patterns and trends. This approach allows for targeted interception of smuggling and seizure of contraband products, leading to disruption and prosecution of organized crime groups involved in the smuggling of contraband tobacco products.

Regular reports on the illicit tobacco situation were provided to Finance and Health Canada. Side bar reports and presentations provided to other key partners and key Ministerial entities upon request, such as the Government of Canada, the Senior Revenue Officials Conference and the Interprovincial Investigations Conference (IIC). The tobacco analysts also regularly briefed and attended meetings with the Department of Finance.

The FTCS-supported criminal intelligence analysts for tobacco have attended the following events:

• Interprovincial Investigations Conference (IIC): The aim is to develop, increase and maintain cooperation among all those who are involved in combating the contraband tobacco market by providing current information and contacts in other jurisdictions.
• U.S./Canada TobaccoDiversion Workshop: The workshop aims to bring together managers, investigators and analysts as well as relevant agencies involved in tobacco enforcement.  The workshop is part of an ongoing commitment by the core agencies to address the growing illicit tobacco market and its cross-border flow through an integrated policing and intelligence-sharing approach.
• The Third Progress Report for the implementation of the Contraband Tobacco Enforcement Strategy (CTES) was released and RCMP is currently working on the fourth Progress Report, and the Program-Led Review Report.

One organized crime group involved in the contraband tobacco market was disrupted during the 2012-13 fiscal year. Further, the RCMP seized approximately 363,000 cartons or unmarked bags of cigarettes and approximately 45,000 kg of fine-cut tobacco. This represents a decrease of approximately 11% for cartons or unmarked bags of cigarettes, and an increase of 41% when compared to seizures made in fiscal year 2011-12.

18.4
Provided status updates on the contraband tobacco market, as well as seizure statistics, at the Department of Finance-chaired Tobacco Enforcement meetings.

Produced an annual assessment of Canada's contraband tobacco market detailing current characteristics and trends.

Coordinated intelligence collection and development activities related to the illicit trade in tobacco.

Collaborated with other agencies such as the RCMP and the Akwesasne Mohawk Police, which has resulted in an increase in targets for examination for both commercial and travellers.

Identified indicators and modus operandi not previously known; identified emerging trends and threats and shared this information with CBSA Regional Offices, and with domestic and international partners, including the World Customs Organization. 

Actively participated in Joint Forces Operations with law enforcement partners across the Regions. Developed and maintained contact with international tobacco.

In 2012-13, CBSA front line officers continued to collect duties and taxes at Ports of Entry on all personal importations of tobacco.

18.5
Assessment and Benefits Services Branch:

• Processed returns and refunds to ensure correctness and maintained systems and reporting capabilities to meet program requirements.

Legislative Policy and Regulatory Affairs Branch:

• Audits and regulatory reviews were performed to ensure compliance with legislative requirements imposed on the manufacture, possession and sale of tobacco products in Canada.
• Information about specific tobacco transactions as well as expert testimony and affidavits, as required, were provided to support RCMP/CBSA enforcement activity.
• Officials participated on a number of committees dealing with the monitoring and control of tobacco products, including those dealing with interprovincial issues.

18.6
Approximately $7.3M has been recovered for all outstanding fines. Over 1,550 fines were settled in 2012-13, compared to 1800 fines in 2011-12, which represents an 18% decrease. Nevertheless, the amount recovered was equal the amount recovered in 2011-12.

Income tax/GST/HST set-offs have accounted for almost $1M in recovered fines. The number of fines registered for set-off as of fiscal year end is 7,407 for a potential recovery of almost $37M. This represents an increase of 411% in the number of fines registered for set-off since 2009-10, which was the first full fiscal year of registration of outstanding fines.

258 individuals were issued a warrant of committal for failure or refusal to pay their fines despite their ability to pay. Of these, 51opted to pay their fine in lieu of incarceration for a total of $99,700 in recoveries. As a point of comparison, 1,550 fines were settled in full and 11,400 were partially settled in 2012-13.

The current inventory of outstanding fines totals over 18,000 fines, a decrease of 15% compared to 2011-12. These 18,000 fines represent an amount of almost $125M. We continue to prioritize the CRA set off (the most cost-effective recovery method, as compared to seizure of assets or committal).

19. Comments on variances (if applicable):

Health Canada -
The spending variance for 2012-13 is attributed to the following factors:

Due to the renewed Federal Tobacco Control Strategy, some of the Healthy Environments and Consumer Safety (HECSB) funds (as a result of the vote transfer) were received late in FY 2012-13 (via Supplementary Estimates B) and a new approach to spending was being implemented. As a result, funds were reallocated on priority departmental program pressures.

Funding for the First Nations and Inuit component of the Strategy was not expended in 2012-13. After a transitional period, Health Canada will work with interested partners to implement evidence and results based tobacco control strategies in a targeted number of on-reserve First Nations and Inuit Communities.

Communications and Public Affairs Branch received funding in Supplementary Estimates B on January 10, 2013. This made it difficult to spend funds in the fourth quarter.

Public Health Agency of Canada launched a new approach in February 2013 to promoting healthy living and prevent chronic disease. This new approach required time to develop innovative partnerships between private and public sectors which took longer than anticipated.

20. Results achieved by non-federal partners (if applicable): N/A

21. Contact information:

Robert Ianiro
Director General
Controlled Substances & Tobacco Directorate Health Canada
Tel: (613) 941-1977

1. Name of horizontal initiative: Defense of Canada Against Third-Party Claims in Tobacco Litigation

2. Name of lead department(s):

Health Canada

3. Lead department PAA Program:

Substance Use and Abuse

4. Start date: 2010-11

5. End date: March 31, 2013

6. Total federal funding allocation (from start date to end date): $45.738M

7. Description of the horizontal initiative (including funding agreement):

The purpose of this horizontal initiative is to defend Canada against third party claims in tobacco litigation. The sources of funding for this initiative are:

• $34,878,000 over three fiscal years from the fiscal framework in Budget 2010.
• Up to $9,000,000 from Health Canada's existing reference levels ($3,000,000 in 2010-11, $3,000,000 in 2011-12, and $3,000,000 in 2012-13).
• Up to $1,860,000 from Agriculture and Agri-Food Canada's existing reference levels ($1,100,000 in 2010-11, $380,000 in 2011-12, and $380,000 in 2012-13).

8. Shared outcome(s):

• To defend Canada against third party claims in tobacco litigation.
• To meet all our legal obligations in a timely manner.

9. Governance structure(s):

The major stakeholders are Health Canada, Agriculture and Agri-Food Canada and Justice Canada. While acting within their respective mandates, the defence effort is coordinated by the Interdepartmental Assistant Deputy Minister Steering Committee on Tobacco Litigation. The committee is co-chaired by the three departments and ensures the management of issues and finances.

Performance highlights:

In light of the favorable decision of the Supreme Court of Canada in July 2011, and with the guidance and support from Justice Canada, the third party claims against the government of Canada in the two class actions related to tobacco taking place in Quebec were dismissed on November 14, 2012.  Health Canada and Agriculture Canada will continue to defend Canada against third-party claims in all tobacco litigation as required.

17. Expected results:

Canada is defended against third-party claims in tobacco litigation and has met its legal obligations. 

18. Contributing activity / program results: Achieved by Health Canada and Agriculture and Agri-Food Canada:

In November 2012, the Quebec Court of Appeal concluded that the Government of Canada is not an appropriate party in the Blais and Létourneau class actions in Quebec. This decision follows the Supreme Court of Canada's unanimous decision in R. v. Imperial Tobacco Ltd. which, in July 2011, confirmed the Government of Canada's position that Canada cannot be held responsable for damages related to the manufacture, design and marketing of cigarettes.  As a result of the decision, expenditures incurred to defend Canada in tobacco litigation during 2012-13 were lower than initially estimated.

19. Comments on variances:

Due to the court decision from the Quebec Court of Appeal in November 2012, which resulted in the removal of the Government of Canada as third party in the Blais and Létourneau class actions in Quebec, less funds than initially anticipated were required to defend Canada in tobacco litigation in 2012-13.

17. Expected results:

Canada is defended against third-party claims in tobacco litigation and has met its legal obligations. 

18. Contributing activity / program results: Achieved by Health Canada and Agriculture and Agri-Food Canada:

In November 2012, the Quebec Court of Appeal concluded that the Government of Canada is not an appropriate party in the Blais and Létourneau class actions in Quebec. This decision follows the Supreme Court of Canada's unanimous decision in R. v. Imperial Tobacco Ltd. which, in July 2011, confirmed the Government of Canada's position that Canada cannot be held responsable for damages related to the manufacture, design and marketing of cigarettes.  As a result of the decision, expenditures incurred to defend Canada in tobacco litigation during 2012-13 were lower than initially estimated.

19. Comments on variances:

* Includes Accommodation and EBP.

Expenditures are lower than expected principally because in November 2012, the Attorney General of Canada successfully defended two actions in warranty brought by tobacco companies, thus removing Canada as a defendant to the class actions.

Although Canada is no longer a party, AAFC shared residual costs estimated to $295K are still being incurred this fiscal year to cover the basic case management by Justice Canada's Quebec regional office.

21. Contact information:

Louis Proulx
A/Director
Health Canada Litigation Support Office
Ottawa, Ontario K1A 0K9

1. Name of horizontal initiative:

Action Plan to Protect Human Health from Environmental Contaminants

2. Name of lead department(s):

Health Canada (HC)/Environment Canada (EC)

3. Lead department PAA Program:

Health Canada / 2.3 Environmental Risks to Health

4. Start date: 2008-09

5. End date: 2012-13 and ongoing

6. Total federal funding allocation (start to end date):

$84.6M and ongoing $18.9M

7. Description of the horizontal initiative (including funding agreement):

Recent surveys show that Canadians are concerned about environmental contaminants and their effect on human health. There is a clear need to ensure that Canadians have credible information on the health impact of chemicals in their environment and the steps that they should take to protect themselves from potential harm.

The Government has already taken steps to address contaminants through the Chemicals Management Plan and the Clean Air Agenda, focusing on substances which have known potential for harming human health and the environment. Both industry and other stakeholders have been supportive of these initiatives but continue to insist that decisions be made based on scientific evidence and the precautionary principle. Monitoring, surveillance and ongoing research is needed to ensure that the effectiveness of interventions to address known potential risks can be assessed and that emerging risks can be detected.

The Action Plan to Protect Human Health from Environmental Contaminants is designed to further protect the health of Canadians from environmental contaminants while increasing the knowledge-base of contaminant levels and potential impacts on health, in particular:

• to foster awareness and provide information for Canadians to take action.
• to identify and monitor trends in exposures to contaminants and potential association with health problems such as asthma, congenital anomalies and developmental disorders.
• to better understand the association between contaminants and illness.

An Environmental Health marketing campaign was developed to help make Canadians aware of the risks that harmful environmental contaminants may pose to their health along with direct actions they can take to reduce these risks and improve their health.  The campaign deliverables include advertising and digital engagement, a national retail engagement program, and development and dissemination of an Environmental Health Guide for Canadians, as well as tailored guides for First Nations and Inuit communities. $13.1M has been allocated to Health Canada from 2008 to 2013 to deliver on the awareness and education campaign, reaching two key audiences: 1) mainstream Canadians and, 2) First Nations and Inuit populations.

$54.5M has been allocated to Statistics Canada from 2008-09 to 2012-13 towards conducting the Canadian Health Measures Survey (CHMS) and $5.6M has been allocated to Health Canada from 2008-09 to 2012-13 to conduct the First Nations Biomonitoring Initiative (FNBI).  The CHMS is used to collect information from Canadians about their general health and lifestyles and includes the collection of blood and urine specimens to be tested for environmental contaminants among other things. The CHMS will not provide data on First Nations on-reserve or Inuit communities. The FNBI is exclusive to First Nations living on reserve, south of the 60th parallel.

From 2008-09 to 2012-13, the Public Health Agency of Canada has been allocated funding in the amounts of $5.9M to enhance surveillance of congenital anomalies and $5.5M to conduct surveillance of developmental disorders.

8. Shared outcome(s):

Reduce health risks to Canadians (particularly vulnerable populations) from environmental contaminants

9. Governance structure(s):

All action plan initiatives take advantage of governance and management structures already established for ongoing government programs such as: the Canadian Population Health Statistics Program, the Chemicals Management Plan, the Healthy Living and Chronic Disease initiative of the Public Health Agency of Canada, as well as components of existing national surveillance systems developed by the Public Health Agency of Canada in partnership with stakeholders.

Each program within Health Canada, the Public Health Agency of Canada and Statistics Canada is fully responsable for the management of initiatives they are leading within the action plan. Consultations and stakeholder involvement are governed through consultative structures and interdepartmental committees already established.

A tripartite governance structure with Health Canada, the Public Health Agency of Canada and Statistics Canada is used to oversee the implementation of the Canadian Health Measures Survey (CHMS). The CHMS will use the existing Canadian Population Health Statistics Program as a governance structure, which includes senior officials from all three federal organizations.

10. Performance highlights:

Planning highlights for this initiative included the continuation of the Environmental Health marketing campaign, focused primarily on providing information and promoting awareness about common indoor environmental hazards, and distribution of Environmental Health Guides.  As well, in 2012-13, the FNBI focused on the analysis and dissemination of biomonitoring results and the First Nations and Inuit Environmental Health Marketing campaign continued to provide and promote tailored information directly to First Nations and Inuit communities and distribute First Nations and Inuit Environmental Health guides.  Capacity was also increased in the provinces and territories for surveillance of congenital anomalies and work continued on the surveillance of developmental disorders, including Autism Spectrum Disorders.  Finally, data collection began for Cycle 3 of the CHMS, while data collection for Cycle 2 was completed during 2012-13, with results expected to be released in April 2013.

* Includes 13% PWGSC accommodation costs where applicable.  Totals may differ within tables due to rounding of figures.

17. Expected results: (from 2012-13 RPP):

Health Canada:

Healthy Environments and Consumer Safety Branch (HECSB), Communications and Public Affairs Branch (CPAB), and First Nation and Inuit Health Branch (FNIHB)

• Distribution of the Environmental Health Guides.
• Increased online discussion of the link between health and home environments.
• Tailored Guides for First Nations and Inuit Fall/Winter and Spring/Summer Outdoor activities are developed and distributed to aboriginal communities.
• Continuation of the Environmental Health marketing campaign (mainstream and First Nations components).
• Tailored environmental health product for seniors 65+ is published and distributed.
• Analysis of biomonitoring data and preparation of a national report on the findings from the First Nations Biomonitoring Initiative.
• Preparation of community reports on health survey results for that particular community.
• Reliable and usable data for First Nation communities, researchers, and government on the health status of First Nations' exposure to environmental contaminants and enable comparison between First Nations and the Canadian population.
• Participants and/or communities to take action to reduce exposure levels to chemical(s) of concern.

Public Health Agency of Canada

• Enhanced Congenital Anomalies Surveillance: increased capacity in the provinces and territories for surveillance of congenital anomalies in their jurisdictions and strengthened networks across Canada for surveillance and research into prevention of congenital anomalies.
• Surveillance of Developmental Disorders: a network for surveillance of autism in Canada and increased public health scientific capacity on autism within the federal government.

Statistics Canada

• CHMS Cycle 1: All data from Cycle 1 will be in the public domain and the CHMS biobank will be available for access by researchers according to published protocols. Access to the data by users and researchers, use of the data files in the Research Data Centers, publications in journals, media and other channels will be tracked and monitored.
• CHMS Cycle 2: Data collection response rates are monitored regularly to ensure adequate representation of the Canadian population by age group and sex. Ongoing data quality control and data quality assurance activities, including observation of the data collection procedures by health experts, are performed to ensure a high data quality level.
• CHMS Cycle 3: Specifications for data collection and processing applications, operations manuals and lab and clinic manuals will be developed in collaboration with health experts, through working groups and advisory committees, and federal partners through the tripartite governance structure between Health Canada, the Public Health Agency of Canada and Statistics Canada. Pilot testing and feasibility studies will determine appropriate operational processes to ensure high response rates and quality data while ensuring adherence to planned resources.

18. Contributing activity/ program results (using specific indicators):

Health Canada

HECSB/CPAB/FNIHB

Continuation of the Environmental Health marketing campaign / Distribution of The Environmental Health Guides:

• The 2012-13 Environmental Health marketing campaign focused primarily on providing information and promoting awareness about common indoor environmental hazards (radon, carbon monoxide, mould, lead) via retail engagement/outreach events.  Activities were deployed in a variety of home improvement stores and "eco" boutiques across Canada, extending the program's reach to a more diverse client base and increasing the campaign's presence in both rural and urban communities.
• A total of 570 engagement events were held at eight different retail chains and independent boutiques over the course of seven weekends from January 19 to March 3, 2013.  Through these events, consumers were educated on the potential environmental risks that may impact their health and how to mitigate them. The events included:
  • Events in 34 Lowe's stores (129 events); 16 RONA stores (112 events); 31 Home Hardware stores (104 events); 33 Kent Building Supplies stores (209 events); and kiosks in terra20, Carbon Environmental Boutique, The Good Planet Company and The Grass Roots Store (four events each).
  • Event promotion to 2.5 million households was achieved through ads in Lowe's flyers.
  • The distribution of 65,000 Hazardcheck: Hazards in your Environment guides, 10,000 Radon: Is it in your Home? brochures, and 3,000 Hazardcheck checklists.
  • More than 34,000 face-to-face conversations were recorded, of which 13,653  were in-depth conversations (that went beyond initial key messages).
  • An increase in sales of air quality and radon testing devices during the campaign. Kent Building Supplies saw a four-fold increase in the sale of radon test kits, and 29% increase in sales of CO detectors. Lowe's saw a 13-fold increase in carbon monoxide detector sales.
• Almost 5,000 in-store feedback forms were collected and a further 218 people completed follow-up post-event surveys. Satisfaction of in-store events was rated at 89.1% ("Information received at the kiosk was useful or very useful") and 97% indicated that they found the Health Canada materials (guides and brochures) helpful.
• The program worked with partner organizations who distributed key messages through their member and organizational outreach, social media marketing channels and online newsletters. Close to 39,000 Canadians were made aware of the campaign via this online engagement of Summerhill, Bullfrog Power, Asthma Society of Canada, the Grass Roots Store, Pollution Probe, the Lung Association of New Brunswick and the Canadian Partnership for Children's Health and the Environment.
• An additional 35,000 Hazardcheck guides were handed out at various Peavey Mart hardware stores, and distributed within communities proximate to the participating retail locations, including libraries, community centers, fire stations, health centers and municipal offices.
• A related Google Adword buy on overall environmental health issues (as part of the Health Canada Digital Engagement Strategy) drove 6,500 visits to the Hazardcheck webpages on HealthyCanadians.gc.ca.

Further activities in 2012-13 fiscal:

• 1,082 enquiries related to environmental health were made to Service Canada's 1-800-O-Canada  public enquiries line.
• The Health Canada Publications Centre processed more than 500 online, web and email orders for the Hazardcheck guide, mailing 5,236 copies.
• The Environmental Health section of the Healthy Canadians website received 36,394 pageviews from October 2012 - April 1, 2013, and the Health Canada website section recorded 40,997 pageviews during the same period, for a total of 77,391 pageviews.
• About thirty environmental health posts appeared on the Healthy Canadians Facebook page.

FNIHB

First Nations Biomonitoring Initiative

The First Nations Biomonitoring Initiative (FNBI) is a multi-year national health survey that will provide new knowledge on the background body burden of environmental chemicals in First Nations people across Canada.  This Initiative also serves to complement the Canadian Health Measures Survey (a parallel health survey of the general Canadian population) to allow comparison of exposure levels of First Nations people with the rest of the Canadian population.  The FNBI is a partnership between Health Canada and the Assembly of First Nations (AFN) and is exclusive to First Nations people living on reserve, south of the 60th parallel.  The AFN is the lead for this project and Health Canada serves as funder and technical advisor.

In 2012-13, the First Nations Biomonitoring Initiative (FNBI) focused on the analysis and dissemination of biomonitoring results to individual participants and communities that participated in the health survey across Canada. As part of the FNBI full survey, 13 First Nation communities (which included over 500 participants) were part of this nationally representative survey.  Specific activities included:

• Providing technical assistance to the AFN in the preparation of the 13 reports to participating communities.  The reports contained individual community results (on over 95 chemicals that were analyzed) and compared their results with the First Nation aggregate data.
• In collaboration with the AFN, attended community presentations to respond to questions of a technical nature on the FNBI results to the communities that participated in the health survey and assisted individuals/communities to decrease exposure to chemicals of concern.
• Last fiscal year, the FNBI pilot project was conducted in two First Nation communities.  Follow-up measures, meetings with the community leadership, and a presentation to the community were required by the AFN and Health Canada's headquarters and regional staff, since community participants showed higher levels of exposure for lead and mercury in one of the communities.
• Review of the FNBI results to compare First Nations exposure levels with the rest of the general Canadian population, under the Canadian Health Measures Survey (CHMS) and provide content to the report on national results, which was produced by the AFN.  Findings were presented in a draft report entitled "First Nations Biomonitoring Initiative National Results" and will be publicly released in summer 2013.

FNIHB/CPAB

In 2012-13, the First Nations and Inuit Environmental Health Marketing campaign continued to provide and promote tailored information directly to First Nations and Inuit communities.

APTN Partnership

A two year partnership with Aboriginal Peoples Television Network (APTN) included hosting of the branded micro-site "Health in Our Hands" featuring an interactive quiz and two APTN produced videos of community members sharing tips on ways to reduce environmental health risks.  During the month of February 2013, there were 306 total visits to the APTN micro-site (aptn.ca/health) on Environmental Health, including 127 views of the environmental videos. The micro-site also linked directly to Health Canada's First Nations and Inuit environmental health website as well as the Healthy First Nations and Inuit Facebook page.  APTN promoted the micro-site by airing a 30 second TV PSA on their television network and by promoting the site through APTN's social media channels, including Facebook posts and Twitter.  The partnership also included Health Canada's participation in the Aboriginal Day Live event in Winnipeg, MB which draws 35,000 Aboriginal attendees annually.

Public opinion research

In March 2013, research was undertaken with First Nations and Inuit to track awareness, perceptions, behaviours, and information needs related to environmental health risks (comparing results to a baseline survey conducted in March 2010), and to assess awareness and recall of the Environmental Health marketing campaign. The final report for this research is expected in June 2013.

Distribution of guides:

• 3,600 copies of the First Nations Environmental Health Home Guide and 600+ copies of the Inuit Environmental Health Guide were ordered online.
• 12,700 copies of the Inuit Kids and Teens Guides and Activity Booklets were distributed directly to 59 elementary schools and high schools in the Inuit region in November 2012.
• 11,400 copies of the First Nations Outdoor Spring/Summer Guides and 11,900 copies of the First Nations Outdoor Fall/Winter Guides were distributed to First Nations communities in September 2012. Distribution of these guides in English and French was completed in collaboration with regional Environmental Health Officers (EHOs).
• 8,800 copies of the Inuit Outdoor Ice Season Guides and 8,800 copies of the Inuit Outdoor Open Water Guides were distributed to Inuit communities in February 2013.  The distribution plan for these guides in English, French and Inuktitut was completed in collaboration with ITK and The Government of Nunavut.
• The First Nations and Inuit Home Guides, the First Nations and Inuit Outdoor Guides as well as the Youth Guides and Activity booklets are all available on the Health Canada website. There were 738 downloads of various environmental health guides, of which 29% were mould related.

Videos:

• The four videos on mould continue to be the most popular videos on the Health Canada YouTube channel with 41,500+ views this year (over 107,000 total views since posting the videos in 2010).

Food safety is a topic included within the Environmental Health campaign for First Nations and Inuit.

• 535 copies of the food safety DVDs (a series of four videos) were distributed in February to EHOs for use and distribution in communities.
• The four videos on food safety were viewed over 6,000 times on YouTube.

Promotion:

• Facebook advertising generated 21,000+ clicks and a Google Adword buy generated 27,000 clicks to the Health Canada environmental health landing page for the First Nations and Inuit campaign.
• Print PSAs were sent out to 210 First Nations and Inuit community print publications.
• There were 102 posts related to environmental health made on the Healthy First Nations and Inuit Facebook page which led to 7,000+ likes, 1,700+ comments and 230 shares by fans.

Online Activity:

• The total page views to the First Nations and Inuit Environmental Health web site section increased by 206% from 46,650 in 2011-12 to 120,625 page views in 2012-13.

Public Health Agency of Canada:

Enhanced Congenital Anomalies Surveillance

• Increased capacity in the provinces and territories for surveillance of congenital anomalies in their jurisdictions
  • PHAC worked with seven provinces and territories to begin implementation of the Memoranda of Agreement that were signed in 2011-12, which aim to strengthen capacity to provide information for the Canadian Congenital Anomalies Surveillance System, and continued discussions with other P/Ts to develop new MOAs.  In 2012-13, efforts focused on developing data sharing agreements between P/Ts and PHAC, conducting data quality assessments and initiating data sharing/transfers.
• Strengthened networks across Canada for surveillance and research into prevention of congenital anomalies
  • PHAC's External Advisory Committee of the Canadian Perinatal Surveillance System provides an ongoing forum to engage stakeholders and provincial/territorial jurisdictions on the Agency's activities to improve surveillance of congenital anomalies, as well as seek expert advice on the system.
  • In the Fall of 2012, the Agency hosted the Joint Annual Scientific Meeting of the International Clearinghouse for Birth Defects Surveillance and Research and the Canadian Congenital Anomalies Surveillance Network, bringing together Canadian and international surveillance expertise for the prevention of birth defects.

Surveillance of Developmental Disorders (including Autism Spectrum Disorders (ASDs))

• Develop a network for surveillance of ASDs in Canada
  • The Expert Advisory Committee and two working groups on surveillance and knowledge translation met during the year to provide advice to the Agency regarding the creation of an ASD surveillance network in Canada.  Through this committee, the Agency developed core elements of its surveillance system, including decisions on what information will be collected.
• Increased public health scientific capacity in autism within the federal government
  • Working with provinces and territories, the Agency completed an environmental scan of Autism Spectrum Disorders programs to identify various data sources, including health, social service and education systems.  Through these collaborative efforts, PHAC achieved consensus on key aspects of the surveillance system, including scope of data collection.
  • PHAC finalized an implementation plan for an ASD surveillance system and as a first step in 2013-14 will invite provincial/territorial participation.

Statistics Canada:

Canadian Health Measures Survey (CHMS)

Cycle 3 (2012-13) Data collection began in January 2012 in Montreal QC, the first of 16 national sites. Data collection response rates are monitored regularly to ensure adequate representation of the Canadian population by age group and sex.

Several new measures in support of environmental contaminants include testing of household tap water for volatile organic compounds (VOCs) and fluoride; hearing tests to support examination of hearing loss and its association with noise exposure/noise pollution; and a Fractional exhaled Nitric Oxide (FeNO) measurement that directly measures airway inflammation. Also included in cycle 3 is an objective test of skin pigmentation. New laboratory measures in blood or urine include VOCs, acrylamide and glycidamide, methyl mercury, some additional organophosphate insecticides such as acephate and malathion, parabens, Triclosan, total immunoglobulin E, vitamin C, fatty acids, reproductive hormones and thyroid status.

Cycle 2 (2009-11) Data collection ended in December 2011. Data files were released in September and November 2012, with environmental contaminant data and the combined cycles 1, 2 file weights expected for release in April 2013. A series of analytical articles, fact sheets and data tables were prepared in conjunction with the data releases on such topics as the prevalence of childhood obesity, high blood pressure, self-reported versus directly measured chlamydia and herpes, and concentrations of blood lead and bisphenol A in the Canadian population. Two articles with a specific focus on indoor air data to be released on May 15, 2013.

Cycle 1 (2007-09) Six applications for studies using stored samples from the  CHMS biobank were deemed technically feasible and were reviewed by the Biobank Advisory Committee (BAC). Two proposals were recommended by the BAC for approval by Policy Committee. Several studies using Cycle 1 data have been published and over 65 studies have applied to use CHMS data through Statistics Canada  Research Data Centre Network  in Canadian universities.

19. Comments on variances:

Health Canada

CPAB:

The $0.3M over-expenditure was funded by internal reallocation from program branches. Funding was utilized for a variety of Environmental Health initiatives to support the Action Plan including retail partnership promotions, media partnerships with APTN, reprinting and distribution of materials and increased cost of follow up to Public Opinion Research.

FNIHB:

The $0.1M surplus was due to the delay in staffing action.

PHAC:

For Developmental Disorders surveillance, the current focus is the development of the autism spectrum disorders (ASD) surveillance system.  Variances stem from the unanticipated challenges associated with the complex nature of ASD and the need to coordinate systems with health and non-health sectors, including:  the need to pool multiple data sources, given the absence of a single repository of proposed data elements; the lack of uniformity across jurisdictions for the identification of ASD; and, a varied state of P/Ts readiness for data capture and capacity.
For Congenital Anomalies surveillance, variances are the result of slower than anticipated negotiations with some provinces and territories to ensure fulsome participation in the surveillance system.

Statistics Canada:

Canadian Health Measures Survey (CHMS): Expenditures were reduced during 2012-13 due to a fire in one of the site trailers which reduced the number of trailers available during the year.  As a result, closer sites were selected using the Quebec/Toronto corridor, which reduced travel and transportation expenses.  During 2012-13 there were no development and preparation costs involved in starting a cycle as these were planned for and completed for Cycle 3 during the two previous fiscal years.  Other reductions were related to the 2012-13 Budget which included cost containment initiatives, the transferring of expenses to Shared Services and reductions due to Workforce adjustment.

20. Results achieved by non-federal partners (if applicable):

Health Canada:  Partnerships in the First Nations Biomonitoring Initiative involved the Environmental Stewardship Unit of the Assembly of First Nations.

• As the Principal Investigator resides with the AFN for the FNBI, it was AFN's responsibility to return individual results to 500+ participants who took part in the national FNBI survey.
• Analyzed biomonitoring data and produced 13 community biomonitoring results reports for the participating communities of the health survey.  AFN provided the analysis between community and aggregate results.
• Presentation of biomonitoring results to participating communities of the health survey to discuss the FNBI results.
• Participation in follow-up measures and community discussions for the FNBI pilot project community where community members had elevated lead and mercury exposure levels as compared to the rest of the Canadian and First Nation populations.
• Analyzed FNBI results to compare First Nation and general Canadian populations' exposure levels.  Prepared draft report entitled "First Nations Biomonitoring Initiative: National Results" which will be publicly released in summer 2013.

21. Contact information:

Suzanne Leppinen, Director
Chemicals Policy Bureau
Safe Environments Directorate
Healthy Environments and Consumer Safety Branch
Health Canada
Ph: (613) 941-8071
suzanne.leppinen@hc-sc.gc.ca

1. Name of horizontal initiative: Chemicals Management Plan

2. Name of lead department(s):

Health Canada (HC)/Environment Canada (EC)

3. Lead department PAA Program:

Environmental Risks to Health (HC)/Substances and Waste Management (EC)

4. Start date: 2011-12 (second phase)

5. End date: 2015-16 (second phase)

6. Total federal funding allocation (start to end date): $516M

7. Description of the horizontal initiative (including funding agreement):

Originally launched in 2006, the Chemicals Management Plan (CMP) enables the Government of Canada to protect human health and the environment by addressing substances of concern in Canada. It is a science-based approach that includes:

• setting priorities and government-imposed timelines for risk assessment and risk management of chemicals of concern.
• enhancing research, monitoring and surveillance.
• increasing industry stewardship and responsibilities for substances.
• collaborating internationally on chemicals assessment and management.
• communicating to Canadians the potential risks of chemical substances.
• engaging industry to inform risk assessment and risk management action while also enhancing trust in the program.

Jointly managed by Health Canada and Environment Canada, the CMP brings all existing federal chemical programs together under a single strategy. This integrated approach allows the Government of Canada to address various routes of exposure to chronic and acute hazardous substances.  It also enables use of the most appropriate management tools among a full suite of federal laws, which include the Canadian Environmental Protection Act, 1999, the Canada Consumer Product Safety Act (CCPSA), the Food and Drugs Act (FDA), and the Pest Control Products Act (PCPA).

Building on lessons learned in the first four years of the program, CMP priority setting was refined and, under the second phase of the CMP, the remaining substances were grouped to facilitate more efficient assessments, industry participation and risk management. Integration across government programs remains critical since many remaining substances are found in consumer, health, drug and other products.

The same core functions continue in phase two of the CMP: risk assessment; risk management, compliance promotion and enforcement; research; monitoring and surveillance; stakeholder engagement and risk communications; and policy and program management.

The following program areas are involved in CMP activities:

In Health Canada:

Health Products and Food Branch:

• Biologics and Genetic Therapies Directorate.
• Food Directorate.
• Natural Health Products Directorate.
• Policy, Planning and International Affairs Directorate.
• Therapeutics Products Directorate.
• Veterinary Drugs Directorate.

Healthy Environments and Consumer Safety Branch:

• Consumer Product Safety Directorate.
• Safe Environments Directorate.
• Environmental and Radiation Health Sciences Directorate.

Regions and Programs Branch

Corporate Services Branch

Pest Management Regulatory Agency

In Environment Canada:

• Environmental Stewardship Branch.
  • Chemicals Sector Directorate.
  • Legislative and Regulatory Affairs Directorate.
  • Industrial Sectors Directorate.
  • Energy and Transportation Directorate.
  • Environmental Protection Operations Directorate.
• Science and Technology Branch.
  • Science and Risk Assessment Directorate.
  • Wildlife and Landscape Sciences Directorate.
  • Atmospheric Science and Technology Directorate.
  • Water Science and Technology Directorate.
• Enforcement Branch.
• Strategic Policy Branch.
  • Economic Analysis Directorate.

For more information, see the Government of Canada's Chemical Substances Portal.

8. Shared outcome(s):

Immediate Outcomes:

• Knowledge, information and data on substances of concern is used by HC and EC recipients to inform risk management, risk communication and stakeholder engagement, research, risk assessment, and monitoring & surveillance activities.
• Canadians and stakeholder groups understand information on the risks and safe use of substances of concern.
• Targeted industry conforms or complies with requirements of risk management measures.
• Targeted industry takes voluntary or enforced action to protect Canadians and the environment.
• Targeted industry understands its obligations to take action to protect Canadians and the Environment.

Intermediate Outcomes:

• Canadians use information on the risks and safe use of substances of concern to avoid or minimize risks posed by these substances.
• Risks associated with harmful substances in humans, the environment, food and consumer products are prevented, minimized or eliminated.

Final Outcome:

• Reduced threats to health and the environment from harmful substances.

9. Governance structure(s):

In meeting their obligations pursuant to the CMP, EC and HC deliver their responsibilities through established internal departmental governance structures. CMP governance is assured through a joint Assistant Deputy Ministers Committee (CMP ADM Committee) and an Interdepartmental Chemicals Management Executive Committee (CMEC). These Committees were established to maximize the coordination of efforts, while minimizing duplication between the two departments.

The CMP ADM Committee provides strategic direction, coordination and a challenge function for the implementation and review of results and resource utilization of the CMP. The CMEC is the management committee at the Director General level to support the development of joint Health Canada/Environment Canada strategic directions.  It is also a formal body for cooperation to ensure timely and concerted actions in implementing the CMP activities in an integrated fashion. The CMEC reports to the ADM Committee, providing recommendations on program implementation, results and resource utilization.

10. Performance highlights:

In 2012-13, HC and EC continued to assess and manage the potential health and ecological risks from the remaining high priority existing substances.  Screening Assessment Reports and Risk Management (RM) strategies for most high priorities were completed and risk management measures continued to be developed, implemented, tracked and monitored.  As of March 31, 2013, the majority of 2012-13 planned risk assessments of the remaining 1500 priority existing substances (to be assessed between 2011-12 to 2015-16) have been completed and, when necessary, RM actions initiated.  As well, all new substance notifications received in 2012-13 were assessed, and risk management instruments developed within mandated timeframes as required.

Health Canada continued to conduct risk assessments and develop and implement risk management measures to address risks posed by harmful chemicals in foods and food packaging materials, consumer products, cosmetics and drinking water while work continued on the re-evaluation of previously approved pesticides according to legislated timelines and requirements under the Pest Control Products Act.

The program continued to conduct research and monitoring to address existing and emerging chemicals of concern, and to inform risk assessment needs and RM activities, including preparation for the release of Cycle two of the Canadian Health Measures Survey (CHMS) biomonitoring results and continuation of Cycle 3 data collection.  Compliance strategies and enforcement plans were also developed and delivered and actions taken to implement these strategies and plans for CMP substances.  The focus in 2012-13 was on delivering compliance promotion activities for the highest priority instruments as determined by the compliance priority setting process.

Numbers above taken from TB Sub Appendix C. Totals may differ slightly due to rounding of figures.

*$9M ($3M/year) from 2012-13 to 2014-15 included for the Banting Retrofit.

Numbers above taken from TB Sub Appendix C. Totals may differ slightly due to rounding of figures.

17. Expected Results:

Health Canada/Environment Canada:

• Science-based information on the risks posed by substances informs risk assessment and risk management processes, as well as monitoring and surveillance activities.
• Information on risks of substances to inform risk management, monitoring and surveillance and research activities.
• Data on use, release, exposure and presence of substances of concern to inform risk assessment, risk management, monitoring and surveillance and research activities.
• Engagement, consultation and communication products to inform the public and stakeholders.
• Risk management measures under CEPA, PCPA, CCSPA and F&DA, or other Acts as appropriate.
• Information on obligations to conform or comply with risk management control measures.
• Inspections, investigations and enforcement actions.

18. Contributing activity / program results (using specific indicators):

A key component of the CMP has been to assess, and manage as appropriate, 4,300 priority existing substances by 2020.  Some 1,100 chemicals were addressed in the first phase of the CMP, including the assessment of 200 of the highest priority substances in the Challenge to industry and as required, risk management actions were initiated. The second phase of the CMP involves the continued assessment and management of the potential health and ecological risks associated with approximately 1,500 substances by 2016 through the substance groupings initiative, rapid screening, and other approaches.

In 2012-13, HC and EC continued to assess and manage the potential health and ecological risks from the remaining high priorities, which include substances from the Challenge to industry, and from the Petroleum Sector Stream Approach, as well as the assessment of other substances deemed to be a priority. Screening Assessment Reports and Risk Management strategies for most high priorities were completed, and risk management measures continued to be developed, implemented, tracked and monitored. Work with other jurisdictions bilaterally and in multinational fora to undertake regional and multilateral efforts to manage chemicals of concerns also continued. For example, in January 2013, Canada successfully participated in negotiations leading to the first global, legally binding treaty to reduce mercury emissions.

As of March 31, 2013, approximately 1,100 of 4,300 substances have been addressed and, when necessary, risk management actions initiated. This is largely consistent with where the program had expected to be at this stage. Six draft assessments representing 25 substances were published on the Chemicals Substances website during FY 2012-13.  In addition, three final assessments representing 57 substances were also published on the Chemicals Substances website in 2012-13.

Targeted risk management activities were taken to address 32 substances.  Five (5) proposed RM instruments were published for 10 substances, including a draft Code of Practice for Butanome Oxime. Fourteen (14) final RM instruments were published for 22 substances, including three Pollution Prevention Plans for Bisphenol A, Siloxane D4 and Isoprene, an amendment to the Prohibition Regulations to add BNST, chlorinated alkanes, PCN and tributyltins as well as Environmental Performance Agreements for Refractory Ceramic Fibre and Bisphenol A. In addition, four Federal Environmental Quality Guidelines were published.

All 504 new substance notifications received in 2012-13 have been assessed and the 23 substances that were assessed to be harmful to human health had at least one risk management instrument developed within mandated timeframes. A revision of the In Commerce List (substances in products regulated under the Food and Drugs Act that were in Canadian commerce between 01 January 1987 and 13 September 2001) has been completed.  During the preparation of the revised list, all 1,922 nominations received from external stakeholders were reviewed, bringing the total of substances on this list to approximately 3,400.

Health Canada continued to conduct risk assessments and develop and implement risk management measures to address risks posed by harmful chemicals in foods and food packaging materials, consumer products, cosmetics and drinking water. Highlights for consumer products included: completing method development and testing of CMP substances (incl. 2-(2-methoxyethoxy) ethanol (DEGME), aromatic amines, and 2-methoxy propanol) to support risk management actions. Consumer Product Safety (CPS) risk assessors reviewed assessment documents from Petroleum Stream 1-3, legacy substances and challenge substances and completed product risk assessments, such as Bis(2-ethylhexyl) adipate (DEHA). Cyclical enforcement projects were put in place to determine compliance levels for children's jewellery and formaldehyde in cosmetics, with appropriate enforcement action taken where non-compliance was identified. A 2012-13 regulatory highlight was the posting of tris (2-chloroethyl) phosphate (TCEP) regulations in Canada Gazette I in November 2012. While work on (2-chloroethyl) phosphate (TCEP) and 2-(2-methoxyethoxy) ethanol (DEGME) regulations advanced in 2012-13, publication of the regulations under the Canada Consumer Product Safety Act in Canada Gazette Part II was deferred to 2013-14.

Health Canada continued to conduct research and monitoring programs to address existing and emerging chemicals of concern, and to inform risk assessment needs and risk management activities. Specific monitoring activities included: preparation for the release of Cycle two of the Canadian Health Measures Survey (CHMS) biomonitoring results in 2013-14 and continuation of Cycle 3 data collection; ongoing data analysis for the Maternal-Infant Research on Environmental Chemicals (MIREC) study; completion of three and continuation of seven monitoring and surveillance projects under the themes of biomonitoring in targeted populations, targeted environmental monitoring, and research to support chemical measurement and the interpretation of biomonitoring results. Health Canada also supported eight biomonitoring, health effects and risk communications projects related to heavy metals (e.g., mercury) and persistent organic pollutants (e.g., PCBs) in Northern and Arctic populations.

Research on the environmental risks to health in support of current CMP themes and priorities continued in order to better understand the exposure to, and effects of, a variety of chemicals that were identified as priorities under the CMP. The research also contributed to the development of better methods for chemical hazard and exposure assessment.  Seven projects are currently underway to provide information on the chemical properties, health effects and methods for exposure assessment of manufactured nanomaterials. Health Canada and Environment Canada managed a joint research program with 14 projects funded through a competitive research allocation process. Those projects were split between Health Canada (10 projects) and Environment Canada (4 projects) and address priorities identified under the following themes: a) Effects, b) Exposure and c) Methods and Tools Development.   Additional CMP research is also underway at Health Canada and is directed towards providing information on some of the remaining information gaps.

It was previously determined that the most cost-effective approach to providing CMP scientists with a modern, effective and efficient laboratory would be to make a one-time capital investment to retrofit two floors of an existing Health Canada laboratory facility. In FY 2012-13, the deconstruction and preliminary design was completed at the Sir Frederick Banting Building, and the design contract was awarded to the successful bidder.

Work continued on substances/products regulated under the Food and Drugs Act, including the development of Environmental Assessment Regulations and non-regulatory initiatives, re-evaluation of food additives and food packaging materials and assessment of food contaminants as indicated by CMP screening assessments and new scientific knowledge.

Work also continued on the re-evaluation of previously approved pesticides according to legislated timelines and requirements under the Pest Control Products Act, as well as on continuing to monitor health and environmental incidents related to pesticides, analyzing trends and sales data, and taking regulatory action as needed.

Targeted public outreach and compliance promotion activities were undertaken with 41 compliance and promotion and 53 public outreach and awareness activities delivered, particularly in support of information gathering for the substance groupings initiative. Educational sessions on chemical safety were delivered to stakeholders such as First Nations and early childhood educators.

EC continued to develop compliance strategies and enforcement plans and deliver related activities, to promote regulatees' awareness and understanding of, and compliance, with regulatory requirements for CMP substances.  Focus was on delivering compliance promotion activities for the highest priority instruments as determined by the compliance priority setting process. For example, in 2012-13, targeted compliance promotion activities were delivered on six risk management instruments, focusing on small to medium sized enterprises and First Nations.  About 5,300 regulatees were contacted through compliance and promotion activities on risk management instruments and Enforcement completed 42 investigations.

19. Comments on variances:

Health Canada -

The surplus for both Health Products and Food Safety and Nutrition are attributed to several factors which include staffing delays, Leave Without Pay, and general turn-over, as well as the extension of contracts beyond the fiscal year.

The surplus in Consumer Product Safety was reallocated internally to facilitate CMP related work.

The surplus in Environmental Risk to Health is a result of several factors.  Efficiencies and cost savings were found in the delivery and operations of the program.  In addition, delays in staffing actions resulted in lower than expected salary expenditures.

Environment Canada

Environment Canada variance is attributable to administrative and operational efficiencies measures introduced further to the Budget 2012 and to an internal reallocation to fund Ministerial priorities.

20. Results achieved by non-federal partners (if applicable):

N/A

21. Contact information:

Suzanne Leppinen, Director
Chemicals Policy Bureau
Safe Environments Directorate
Healthy Environments and
Consumer Safety Branch
Health Canada
Ph: (613) 941-8071
suzanne.leppinen@hc-sc.gc.ca

Greg Carreau, Executive Director
Program Development and Engagement
Program Development and Engagement
Science and Risk Assessment Directorate
Environment Canada
Ph: (819) 953-6072
greg.carreau@ec.gc.ca

1. Name of Horizontal Initiative: Food and Consumer Safety Action Plan (Action Plan)

2. Name of lead department(s):

The lead is shared between Health Canada (HC), the Canadian Food Inspection Agency (CFIA), the Public Health Agency of Canada (PHAC), and the Canadian Institutes of Health Research (CIHR).

3. Lead department PAA program:

• HC: Health Products, Consumer Products Safety, Pesticide Safety and Food Safety and Nutrition.
• CFIA: Food Safety Program.
• PHAC: Health Promotion, Chronic Disease Prevention and Control, and Infectious Disease Prevention and Control.
• CIHR: Health and Health Services Advances.

4. Start date of the Horizontal Initiative:

Fiscal Year 2008-09.

5. End date of the Horizontal Initiative:

Fiscal Year 2012-13 (and ongoing).

6. Total federal funding allocation (start to end date):

$489.3M over five years ending in Fiscal Year 2012-13 (and $126.7M ongoing).

7. Description of the Horizontal Initiative (including funding agreement):

The federal government is responsable for promoting the health and safety of Canadians. A key part of this role is ensuring that the food, health and consumer products used by Canadians are safe. Adverse consequences associated with unsafe products impact not only the Canadian public, but also the Canadian economy. The Action Plan is a horizontal initiative aimed at modernizing and strengthening Canada's safety system for food, health and consumer products. A number of high-profile incidents, such as lead and ingestible magnets in children's toys, foodborne illness outbreaks, and the global withdrawal of some prescription medicines, have underscored the need for government action.

The Action Plan modernizes Canada's regulatory system to enable it to better protect Canadians from unsafe consumer products in the face of current realities and future pressures. The Action Plan bolsters Canada's regulatory system by committing to amending or replacing outdated health and safety legislation with new legislative regimes that respond to modern realities, and by enhancing safety programs in areas where modern legislative tools already exist. The Action Plan helps to ensure that Canadians have the information they need to assess the risks and benefits associated with the consumer and health products they choose to use, and to minimize risks associated with food safety.

The Action Plan is an integrated, risk-based plan and includes a series of initiatives that are premised on three key areas of action: active prevention, targeted oversight and rapid response. We focus on active prevention to avoid as many incidents as possible and work closely with industry to promote awareness, provide regulatory guidance, and help identify safety concerns at an early stage. Targeted oversight provides for early detection of safety problems and further safety verification at the appropriate stage in a product's life cycle. To improve rapid response capabilities and ensure the government has the ability to act quickly and effectively when needed, we work to enhance health and safety risk assessments, strengthen recall capacity, and increase the efficiency in responding and communicating clearly with consumers and stakeholders.

8. Shared outcome(s):

• Increased knowledge of food risks and product safety (scientific and surveillance/monitoring).
• Increased industry awareness and understanding of regulatory requirements.
• Increased industry compliance with safety standards.
• Increased consumer awareness and understanding of safety risks associated with health and consumer products and food.
• Strengthened oversight and response to safety incidents.
• Increased consumer confidence in health and consumer products and food.
• Increased trade-partner confidence in Canadian controls, which meet international standards.
• Increased availability of safe and effective products.
• Level playing field where imports can be demonstrated to meet Canadian requirements.

9. Governance structure(s):

The Minister of Health and the Minister of Agriculture and Agri-Food Canada have joint responsibility and accountability for results, and for providing information on progress achieved by the Action Plan.

A Governance Framework has been established and endorsed by all of the partner departments/agencies. To facilitate horizontal coordination, the following Director General (DG)/Executive Director (ED) level Task Forces have been established:

• Legislative and Regulatory Task Force.
• Health Products Task Force.
• Consumer Products Task Force.
• Food Task Force.
• Communications Task Force.

These Task Forces report to a DG/ED level Coordinating Committee. An Assistant Deputy Minister (ADM)/Vice President (VP) level Steering Committee provides direction to the Coordinating Committee. An Oversight Committee of Deputy Heads facilitates the provision of high level guidance to the Steering Committee.

Health Canada's HPFB provided the Secretariat function for the Action Plan until April 2012 when it was transferred to Health Products and Food Branch (HPFB).  The Secretariat provides the oversight and integration of performance against commitments, and providing advice to senior management.

Health Canada's HPFB has primary responsibility for implementing Action Plan activities related to health products with support from Health Canada's SPB, Regions and Program Branch (RAPB) and the Canadian Institutes of Health Research (CIHR) on one initiative (increased knowledge of post-market drug safety and effectiveness).

Health Canada's Healthy Environments and Consumer Safety Branch (HECSB), RAPB and the Pest Management Regulatory Agency (PMRA), along with the Public Health Agency of Canada (PHAC), work together to implement Action Plan activities related to consumer products. The Canadian Food Inspection Agency (CFIA), HPFB, RAPB and the PHAC work together to implement Action Plan activities related to food safety.

The Communications and Public Affairs Branch (CPAB) - formerly Public Affairs, Consultation and Communications Branch) provides communications support.  CPAB coordinated many of the horizontal Departmental activities to develop a consistent Departmental approach to communications.

10.  Performance Highlights

The FCSAP continues to deliver on the three areas of action:active prevention, targeted oversight and rapid response.  Due to the large number of organizations involved, please refer to sections 18 for specific highlights of achievements in the individual program areas.

HC 17.1 a - Expected results for 2012-13: (Active Prevention for Health Products)

The Health Products program will initiate regulatory change to include regulatory oversight of the manufacturing of active pharmaceutical ingredients to improve the safety, quality and efficacy of health products. To increase awareness and compliance with regulatory requirements, Health Canada continues to engage in pre-submission meetings with industry, with the ability to better document, track, monitor and evaluate the exchange of information. These meetings provide an opportunity for the drug submission sponsor to obtain feedback regarding areas of concern prior to filing a submission. In addition, as part of the lifecycle approach, and in the absence of enabling legislation, Health Canada continues to implement an interim strategy for development and review of Pharmacovigilance Plans (PvP) and Risk Management Plans (RMP) with the aim of generating better and new information concerning health products during the pre or post-market phases. A PvP, which can be requested by Health Canada or submitted voluntarily by the manufacturer, identifies and characterizes known or potential safety concerns. RMP, which include a PvP component plus additional risk minimization activities, provide proposals on how to mitigate any identified or potential safety risk by providing additional assurance that the manufacturer has measures in place to react and act quickly if new information concerning the product emerges once on the market. The Active Pharmaceutical Ingredient (API) Inspection Program is dependent on the coming into force of the API regulations.  Preparatory work on inspection training, compliance and promotion work continue while these regulations are pending.

Expected Results: Increase industry awareness and knowledge of regulatory requirements; enhance knowledge of post-market health products safety risks to inform decisions; increase oversight of the risk management and risk mitigation strategies for health products; increase safety of APIs through industry compliance with the Food and Drug Act (FDA) and its Regulations; improve timeliness of pre-market reviews; increase awareness and understanding of the safe use of health products by consumers and health care professionals.

HC 18.1 a - Results Achieved in 2012-13 (Active Prevention for Health Products):

Risk Management Plans/Risk Management and Mitigation Plans
There has been a consistent annual increase in industry submitted Risk Management Plans (RMP) and Risk Management and Mitigation Plans (RMMP) to Health Canada.  In 2012-13, there were 82 RMPs and 50 RMMPs (RMP follow up information) submitted by industry.  Health Canada completed 125 RMPs and 51 RMP follow up in 2012-13. This represents an increase over the 86 RMPs and 37 RMMPs completed in 2011-12. In the 2012-13 reporting year, 96% of the RMP reviews were completed within the 90-day performance standard.

Pre-Submission Meetings
In 2012-13, Health Canada organized a total of 71 pre-submission meetings with industry to discuss biologics, radiopharmaceuticals and genetic therapies. Of those 71 meetings, 31 were for the pre-clinical trial applications, 15 were for Supplemental New Drug Submissions, and 25 were for New Drug Submissions.

Pharmaceutical Drugs received overall 257 meeting requests of which 194 meetings were held face-to-face, through teleconference, or through written correspondence to address the items raised by sponsors in their meeting requests.  In addition, the regulatory staff responded to phone calls/e-mails from sponsors on regulatory matters on a daily basis.  Specific to the Oncology pre-submission meetings pilot, in 2012-13, 46 oncology pre-submission meeting requests were received, an increase from last year's 27.  Of the 42 meetings approved 27 were held, 20 relating to New Drug Submissions (NDS) and seven Supplementary New Drug Submissions (SNDS).

Combined, ten have not yet filed and four are still at the meeting stage.  Of the fourteen submissions filed, two are in screening, six are in review, four were issued a Notice of Compliance (NOC) to market and one was issued a Notice of Deficiency (NOD).   Due to the large number of variables and complexity involved in scientific-based decision making, it is not feasible to attribute an increased efficiency or different review outcome to the fact that a pre-submission meeting was held.  Pre-submission meetings do, however, allow for earlier scoping of key issues that could arise during review.  For example, they facilitate earlier discussion in the review process of the submission or of possible scientific issues by the review team, such as at a review team's "kick-off meeting".  Pre- submission meetings also provide an opportunity for Health Canada to hear from Canadian clinical experts during the meetings and to pose questions directly to them.

In addition to the above, internal and external surveys of the pre-submission meeting pilot have been completed and the information received will be utilized in future improvement plans.

Patient and Consumer Participation Pool
As a result of the 2012 Federal Budget decisions, the activities performed by the Office of Consumer and Public Involvement (OCAPI), which included work towards this initiative, were reallocated within the Branch and were carried out using existing resources.  The Patient and Consumer Participation Pool (PCPP) has been revised to meet existing departmental capabilities and was successfully transitioned to a new host within the Branch.  The PCPP members were informed and involved as the pilot was transitioned. A revised methodology including a refined matching criteria process and new Privacy Impact Assessment, were created.  Two consultations underway have drawn on the PCPP.

Expert Advisory Committees
Health Canada continued to participate in the HPFB Secretariat Manager's Network by providing input and contributing to the improvement of standard operating procedures and guidance.  A departmental guidance on Advisory Committees was finalised and posted on the website in 2012.

Furthermore, advice or recommendations received from external experts through our scientific advisory bodies, which Health Canada considers when making regulatory decisions, is made available to the public on the Health Canada website.  As a result of Health Canada's web-reduction initiative that came into force this year, only two years of proceedings will remain publically available at any given time at http://www.hc-sc.gc.ca/dhp-mps/prodpharma/activit/sci-com/index-eng.php

The Therapeutic Products Directorate of Health Canada is striving to increase openness and transparency to external stakeholders.  To promote this goal within scientific advisory committee meetings, external stakeholders are being permitted to observe portions of the proceedings, provided no confidential business information is being discussed.  To this end, a protocol was developed to provide guidance on how the Chair and Secretariat of a Scientific Advisory Body should manage requests for Observer Status for any given meeting.  This protocol was piloted in the 2012-13 fiscal year and positive feedback has been received from both observers and committee members.

In addition, all therapeutic product committees have been made compliant with Departmental guidance on declaration of conflicts of interest and affiliations.  These declarations are posted on Health Canada's website for all members of our committees and panels.

Six committee meetings were held from April 2012 to March 2013 (one panel held on March 20, 2012).

Social Media
Health Canada continued to encourage social networking and conversations among consumers.  An integrated Digital Engagement strategy was developed to provide Canadians with credible health and safety information when and where they need it.  The first year of this strategy focused on building the community on the Healthy Canadians and Canadiens en santé Facebook pages. By March 31st, 2013, the Healthy Canadians English and French Facebook pages had 14,073 fans.

Health Canada's Twitter and YouTube channels also continued to provide health and safety information to Canadians with more than 2,000 subscribers to YouTube and approximately 70,000 followers on Twitter.

Drug Approvals (Interim funding)
In 2012-13, Health Canada was successful in issuing 90% of decisions within theperformance target overall for brand name new drug submissions.  When reported separately, performance for New Drug Submissions (NDS) was 96% (65) and for Supplemental New Drugs (SNDS) 95% (177).   For Generic Drug submissions, 24% (87) met target for Abbreviated New Drugs Submissions (ANDS) and 59% (48) for Supplemental Abbreviated New Drug Submissions (SANDS). We continue to make progress, but a performance backlog remains.

With respect to Health Canada's contribution toward enabling timely access of safe drugs for Canadians, in 2012-13, 100% (16) New Active Substance (NAS) approvals were made within performance targets.  All 16 approved are now marketed in Canada.
(Note these figures include 1st and 2nd decisions for FY 2012-13.  All numbers are subject to change pending the official annual TPD submission performance report.)

Consumer Information Strategy for Health Products
In 2012, Health Canada published a draft guidance document for broad consultation entitled, Product Monograph - Part III: Consumer Information. Consultation feedback has been received by the Department on ways to improve the clarity, readability, and ease of use of the Product Monograph Part III: Consumer Information (for pharmaceuticals and biologics).  The analysis of the comments has now been completed and a final version of the guidance document, along with the associated templates will be published this year.

In the 2012-13 fiscal year, Health Canada also initiated a similar project with a focus on the Part I: Health Professional Information, and Part II: Scientific Information sections of the Product Monograph.  Pre-consultation activities were planned, including a targeted 30 day on-line survey and stakeholder engagement meetings.  The goals of these activities were to gather information on the Health Canada-authorized Product Monograph as a source of Canadian drug product information and the ease of use of Part I: Health Professional Information; and Part II: Scientific Information, for health professionals.

Both activities also support the HPFB Plain Language Labelling initiative which aims to improve the readability, ease of use and ease of access of drug product labels through regulatory changes.

The Canada-United States Regulatory Cooperation Council (RCC) is a government wide initiative aimed at reducing regulatory differences between the two countries to the extent feasible.  One of these initiatives, co-led by HPFB and U.S. Food and Drug Administration (FDA), is the Over-the-Counter (OTC) Products Common Monograph project.  In January 2013, the launch of the first pilot initiative was launched and common cold indications for certain over-the-counter antihistamine ingredients were selected as the first area of alignment.  Efforts will be made to develop and adopt aligned monograph elements (labelling requirements, including indications, warnings, conditions of use, and any other information that may be required for optimal, safe and effective use of the product).  This initiative is the first of its kind between Canada's HPFB and the United States FDA and falls within the Regulatory Cooperation Council's (RCC) two-year mandate.  The initiative has provided an excellent opportunity for relationship-building between HPFB and the FDA, which has led to collaboration and discussion on issues related to OTC drugs, beyond the pilot monograph.  Canada and the FDA will provide stakeholders with an opportunity to comment on the content of the Canadian and the United States draft monographs in the second half of 2013.  Further information on the work plan can be found on the  Canada's Economic Action Plan website.

In 2011, the Office of the Auditor General (OAG) recommended that Health Canada improve processes to implement safety assessment recommendations for marketed drugs. In response, Health Canada finalized key post-market surveillance activity performance standards, implemented a new systematic process for the management of and notification of safety assessments, and developed formalized procedures for communicating internally on safety assessment recommendations.  In addition, the Department launched the Safety Labelling Stakeholder Notification System on Health Canada's website in February 2013. Monthly information updates and/or new safety information are now being posted on the Health Canada website for brand name pharmaceutical drug products. These efforts will ensure that Canadians and health care professionals have timely new drug safety information.

Additionally, Health Canada continued to process and published 3,315 product monographs to the Health Canada website this year (for pharmaceutical drugs and biologics).

Summary Basis of Decision (SBD) documents explain why Health Canada authorized certain drugs and medical devices for sale in Canada. The documents include regulatory, safety, effectiveness and quality (chemistry and manufacturing) considerations. Notice of Decisions (ND) documents, posted before SBDs, inform the public of the authorization and provides some general information about the decision and product itself.

Summary Basis of Decision (SBD) Project
In June 2012, Health Canada launched Phase II of the SBD project.  Phase II increases the transparency of the drug and medical device review process and provides Canadians with improved access to information about approved products.  Phase II became effective with the publication of a Notice, Frequently Asked Questions document and Phase II Reader's Guide for Drugs and Medical Devices on Health Canada's website.  SBDs are more streamlined compared to Phase I with more information about Health Canada's risk/benefit analysis, as well, all eligible Notices of Compliance (NOCs) and licenses issued after Sept 1, 2012 will be included within the Phase II scope and they will also be accompanied by a post-authorization activity table (PAAT) for drugs or post-licensing activity table (PLAT) for devices, as applicable.

Additionally, Health Canada published 19 Notices of Decision and 35 Summary Basis of Decision documents (for pharmaceutical drugs, biologics and medical devices) on its website.

The Active Pharmaceutical Inspection Program
In FY 2012-13, work continued on amending the Food and Drug Regulations to include regulatory oversight of Active Pharmaceutical Ingredients (APIs).  Amendments were pre-published in Canada Gazette (CG)I on September 29, 2012 for a 75-day comment period, and were published in CGII early in FY 2013-14.  The amendments will come into force on November 8, 2013 and will include EL requirements for fabricators, package/labellers, testers, importers of Active Ingredients.  The regulatory amendment generally imposes Good Manufacturing Practices (GMPs) on the fabrication, packaging/labelling, testing, storing and transport of all AI.

During the year, efforts were focused on preparing for the implementation of the regulatory amendments, which will include a new licensing and inspection program.  Activities in FY 2012-13 focused on the updating and development of guidance, industry education and program planning in preparation of a new licensing and inspection activities.

Several guidance documents related to the regulatory amendments were developed or updated.  The guidance document: ""Good Manufacturing Practices (GMP) for Active Pharmaceutical Ingredients (APIs) Guidelines (GUI-0104)" was developed to outline expectations of regulated industry to comply with the new GMP requirements.  "Guidance on Evidence to Demonstrate Drug GMP Compliance of Foreign Sites (GUI-0080)" was also revised to incorporate requirements for foreign fabricators, packagers/labelers and testers of APIs.   The Guidance on DELs and Drugs Establishments Licensing Fees (GUI-0002) is also being updated.  These documents are expected to be published in the fall of 2013 and will provide guidance to industry on how to comply with the Regulatory amendments.  During FY 2012-13, Health Canada also conducted a number of Compliance Promotion Visits with industry to inform and educate them of the new Regulations and guidelines.

In preparation for implementation of the new licensing and inspection programs, Health Canada developed a phased in approach for the implementation of the new Regulations to provide industry with a transition period to adjust to the new requirements. The approach will allow for a three month period (to February 8, 2014) for industry already operating to submit an establishment license application to Health Canada, and during this time, the Department will not focus compliance efforts on them unless a risk to health is identified. Industry that has not been previously operating will be required to obtain their Establishment license prior to conducting activities. Health Canada will implement the new inspection program prioritizing new establishments conducting fabrication, packaging/labeling, testing, and importation activities as well as using a risk-based approach.

Performance Indicator: Year-over-year increase in PvP/RMP submitted by industry.
(Pharmacovigilance Plans (PvP) and Risk Management Plans (RMP))
Number of pre-submission meetings per year.

HC 17.2 a Expected results for 2012-13 (Active Prevention for Consumer Product Safety):

The Consumer Product Safety program will provide information to consumers and work closely with industry to promote awareness of health risks and regulatory requirements related to consumer products.

Expected results: Increased consumer/industry awareness of health risks and regulatory requirements related to consumer products.

HC 18.2 a Results Achieved in 2012-13 (Active Prevention for Consumer Product Safety):

Consumer Product Safety (CPS) successfully reached out to industry of all sizes and communicated key messages to thousands of consumers related to product hazards through publications like Is Your Child Safe and Information for Art Class Teachers along with consumer awareness campaigns like Toy Safety Campaign and Poison Prevention Week, Healthy Canadians and a Small Retailers Campaign. Overall, in 2012-13 CPS distributed 315,974 copies of 11 of publications. CPS regional officials carried out 233 outreach activities, more specifically presentations and displays targeted consumers, parents,  industry head offices directly, industry trades shows, associations, chambers of commerce, provincial health care organizations, and other special interest and multiplier groups (e.g. teachers).

While Public Opinion Research was not conducted on Consumer Products in 2012-13, a program evaluation survey was conducted as part of the Consumer Products Component program evaluation which provides data on consumer and industry awareness.  NOTE: The survey targeted participants in Consumer Product Safety Act (CCPSA) information sessions and subscribers to Health Canada's Consumer Product Safety electronic newsletter and/or the CCPSA electronic newsletter and is therefore not representative of the general population.

Highlights include:

Level of awareness

• 92% of industry stakeholders who responded to the survey were aware of the new Canadian CCPSA, including 68% who first heard of it through Health Canada sources. Eight percent (8%) of industry representatives were not aware of the new Act.
• About half of consumers were aware of the new CCPSA, including 36% who heard of it through Health Canada sources.
• 45% of all respondents (including industry and consumers) first heard of the new CCPSA from Health Canada sources.

Dissemination mechanism/source(s) of information received/viewed:

• 97% of consumers were aware of consumer product advisories, warnings, and recalls. Overall, 92% said they had used this information.
• 95% of consumers were also aware of the Health Canada Consumer Product Safety website, with 76% having used the information.
• 80% of consumers were aware of the product safety factsheets, and 55% had used them.
• 66% of consumers were aware of information on Health Canada's website about the CCPSA, but only 31% had used it.
• 45% of consumers were aware of the information that Health Canada makes available through social media, but only 10% had used it.

Work in 2012-13 also focused on improving the efficiency and effectiveness of CPS's public communications and advanced engagement with consumers and industry. This work will continue in 2013-14.

With respect to consumer and clinical radiation protection activities under the Radiation Emitting Devices Act (REDA), Health Canada responded to 230 requests for interpretation/technical advice to industry under REDA.

Health Canada has completed the following Safety Codes/guidelines/regulations:

• Safety Code 6 completed and is being reviewed by the Royal Society of Canada.
• Mammography Safety Code completed and is being prepared for web posting.
• Cabinet X-ray Guidance Document completed and ready for web posting.
• Tanning Equipment Regulation published in CGI February, 2013.

To increase consumer awareness of health risks associated with radiation emitting devices, the following documents were published on Health Canada website:

• It's Your Health- Noise Induced Hearing Loss
• It's Your Health- Electric and Magnetic Fields from Power Lines and Electrical Appliances

The following advisories were posted on the Healthy Canadians website:

• Hand Held Lasers or Laser Pointers May Cause Permanent Vision Damage and Burns
• Turn down the volume to protect your hearing health

Web Development
A new Recalls and Safety Alerts web application was launched on the Healthy Canadians website to improve Canadians' access to information to help them protect their health and safety and that of their families. The application streamlined eight different types of risk communications, including advisories, warnings and recalls, with datasets from six different sources, into one database. The content management system also allows information to be shared with Canadians more quickly. A standard, accessible and user-friendly publishing template was developed, allowing for a more consistent interface to visitors of the Recalls & Safety Alerts section of the Healthy Canadians website.

The Recalls and Safety Alerts web and updated mobile application provide an easy to use, one-stop resource for information on recalls and advisories related to health and consumer products, food and vehicles in Canada.  In total, 17,559 new recalls and safety alerts pages were added (English and French).

A marketing campaign advertised the new Recalls and Safety Alerts web application and directed Canadians to the main page of the Healthy Canadians website. Prior to the November 2012 launch of the campaign, the main page of the Healthy Canadians website received an average of 32,722 visits per month. Since the campaign launched, the main page receives an average of 344,244 visits per month.  Additionally, as of March 31st, 2013, the mobile app had been downloaded over 34,000 times.

CPAB continues to add consumer-focused content to the Healthy Canadians website with 522 new consumer pages added in 2012-13 (English & French).  The average time a visitor spends on the Healthy Canadians website also increased by 23% per page to 2 minutes and 20 seconds, showing more engagement from visitors.

To increase awareness of health and safety risks associated with food and consumer products, the following It's Your Health articles were published on the Health Canada website:

Chemicals and Your Health
Tanning and its Effects on Your Health
Insulin Pumps

Additionally, the contents for the following It's Your Health articles were updated:

The Safety and Effectiveness of Generic Drugs
Sodium
Cool-Mist Humidifiers
The Safety of Compact Fluorescent Lamps
Second Hand Smoke
The Safe Use of Cookware
Insect Repellents
Electric and Magnetic Fields from Power Lines and Electrical Appliances
Health Risks of Asbestos
Infant Botulism
Noise-Induced Hearing Loss
Lead and Human Health

Public Inquiries
A Service Level Agreement (SLA) with Service Canada was put in place in May 2012 to create efficiencies with telephone inquiries.  Health Canada's toll free number is now answered by employees of Service Canada.  This SLA allows Health Canada to provide extended hours of service to Canadians, field a larger volume of calls and respond more efficiently to email inquiries. In 2012-13, 19,845 telephone and 4,305 email inquiries were received for food and product safety information.  From 2012-13, 1,051,120 food and product safety publications were shipped.

Performance indicators: % by target population aware of information related to consumer product safety and related to exposure to consumer products by: level of consumer awareness; type of target group and # reached; planned industry outreach activities completed by level of establishment; and product category.

HC 17.3 a Expected results for 2012-13 (Active Prevention for PMRA):

Pest Management Regulatory Agency (PMRA) encourages and facilitates industry development and adoption of quality assurance and stewardship programs for the safe manufacture and subsequent selection and use of pesticides and other consumer products containing pesticides. Retailers of pest control products often rely on their distributors for validation of access to products with lapsed registrations, or which have never been registered. Work under this strategy fosters an increased knowledge of the requirements of the Pest Controls Products Act (PCPA) and an awareness of the tools available to validate the status of the pest control products and their label information. These initiatives are critical in promoting the safe and proper use of pesticides and ensuring risk reduction practices are established along the entire supply chain. In addition, stakeholders are engaged in order to test assumptions about the ability and will to comply with product recall or phase-out requirements. This includes such considerations as whether users can follow through with specific requirements when the financial implications are significant.

Expected results: Increased awareness and understanding of product safety obligations, standards and regulatory requirements by industry.

HC 18.3 a Results Achieved in 2012-13 (Active Prevention for PMRA):

The PMRA disseminated outreach material and information to various targeted populations as well as to the general public through PMRA's Information Service and in online and print publications throughout Canada.

Support was also provided to facilitate participation at fairs, exhibits, and consumer-oriented events, in order to promote pesticide safety and responsable pesticide use.

Performance indicators: % of the target population aware/engaged/confident regarding risks and regulatory activities; # of complaints and/or incidents; # of industry situations noted and self-corrected; # violations where absence of knowledge of requirements is the cause; and # of stakeholder partnerships formed.
Targeted Oversight

HC 17.1 b Expected results for 2012-13 (Targeted Oversight for Health Products):

The Health Products program's ability to make and support admissibility decisions at the border as they relate to health products will be strengthened through the establishment of a national border integrity program, which will include among other initiatives: a national standardized process for the handling of health products at the border; establishment of service standards between Canada Border Services Agency (CBSA) and Health Canada; and, undertaking public education activities to inform Canadians of risk associated with the importation of non-compliant health products. In addition, Health Canada will continue to enhance the post-market surveillance elements of the program through increased efforts focused on review of Periodic Safety Update Reports (PSURs) - documents that summarize the worldwide safety experience of a health product at pre-established post-authorization times. The Department will continue to work with its partners to increase reporting of adverse drug reactions through the Hospital-Based Mandatory Reporting project for Adverse Drug Reactions. Implementation of mandatory reporting is however dependent upon passing of relevant enabling legislation. If new legislation is not passed, Health Canada will continue requesting the reports from the hospitals on a voluntary basis, and will continue to coordinate efforts with provincial and territorial agencies to promote voluntary reporting.

In partnership with the Canadian Institutes of Health Research (CIHR), Health Canada has established the Drug Safety and Effectiveness Network (DSEN) (a pan-Canadian network of centres of excellence in post-market pharmaceutical research) in order to fund studies that will inform pharmaceutical decision-making across the health care system. Please refer to Federal Partner #4 CIHR for DSEN's Expected Results and Performance Indicators.

Expected Results: The TB submission anticipated annual doubling of PSUR volumes (baseline was 125/year in 2007-08), presuming that relevant legislation would be passed in 2010-11. Given that Adverse Reactions are not predictable, it is not possible to set targets related to the volume of reports expected in any given year. Since the Border Integrity Program is reactive, there are no set targets; however, admissibility decisions are tracked and reported quarterly.  Increased knowledge of post-market drug safety and effectiveness to inform decisions; Increased capacity in Canada to address priority research on post-market drug safety and effectiveness.

HC 18.1 b Results Achieved in 2012-13 (Targeted Oversight for Health Products):

Periodic Safety Update Reports (PSURs)
Health Canada performed 301 Level 1 Periodic Safety Update Reports (PSUR- L1) and 61 Level 2 Periodic Safety Update Reports (PSUR- L2) in 2012-13. More than 95% of these reviews for both Level 1 and Level 2 PSURs were completed within performance standard.

Border Integrity Program
In FY 2012-13, over 50,000 admissibility recommendations of imported health products were made by Health Canada.   Health Canada also worked with the CBSA and other partners to streamline processes and help ensure common decision-making processes for border referrals through the development of an Annex to the Umbrella Memorandum of Understanding with the CBSA that defines the roles and responsibilities of HC and CBSA clearly and simply.  Once finalised, efforts will be focused on developing and monitoring service standards.

Post Market Reporting Compliance Inspection Program (PMRC)
In 2012-13, the PMRC program was renamed to the Good Pharmacovigilance Practices (GVP) program to align HC more closely with our international counterparts.  Over the year, more than 80 inspections of the industry's systems for adverse drug reaction and post-approval reporting were conducted. To enhance the efficiency and effectiveness of the program, a risk-based approach for inspection scheduling was implemented.  Under this approach, the establishments are selected based on a variety of criteria including the compliance of the establishment, information on the drug products and information on adverse drug reactions.

Additionally, the new guidance document Good Pharmacovigilance Practices (GVP) Guidelines (GUI-0102) was published on February 11, 2013.  That document provides interpretive guidance to industry on the expectations of inspectors with respect to the adverse drug reaction and post-approval reporting requirements when conducting GVP inspections.  Furthermore, the revised document Risk Classification of Good Pharmacovigilance Practices (GVP) Observations (GUI-0063), also published on February 11, 2013, better informs industry on how Health Canada classifies observations according to their risk.

Drug Safety and Effectiveness Network (DSEN)
Also see: DSEN, Canadian Institutes of Health Research, Targeted Oversight for CIHR results and total allocation (from start to end).

The partner organizations (CIHR and HC [Strategic Policy Branch and Health Products and Food Branch]) continued to collaborate on a number of DSEN processes:

• Participation in the CIHR-led evaluation of DSEN's design and implementation.  Results from this initial evaluation will form the foundation for future evaluations (including those which will be conducted on a five-year cycle, as per Treasury Board requirements) and help inform possible refinements to DSEN processes, programs, and strategic activities (HPFB and SPB).
• Collaboration to enhance the prioritization process for DSEN research queries to reflect pan-Canadian needs for evidence on post market safety and effectiveness (HPFB and SPB).
• Participation in the DSEN Science Advisory Committee (HPFB).
• Coordination of the DSEN Operational and DSEN Executive Working Group meetings, to maintain and strengthen the working partnership (SPB).
• Exchange of DSEN information with the Federal Provincial Relations Division to circulate via the Health Support Committee (SPB).
• Facilitation of communication with Provincial and Territorial government representatives to identify opportunities for collaboration, in the context of such collaborative bodies as the Pharmaceutical Directors Forum, Expert Working Groups, etc. (SPB).
• Participation in and contribution to the HPFB-led, DSEN Health Canada Implementation Team meetings to maintain awareness of the DSEN policy objectives (SPB).
• Collation, review and forwarding of research queries from Health Canada (HPFB) staff to the DSEN Coordinating Office (within CIHR) for consideration as part of the Network's prioritized national research agenda.  Health Canada continues to forward proposed research queries for the DSEN to investigate.  The Health Canada DSEN Implementation Project Team was established by HPFB in 2009, with representatives from HPFB and FNIHB.
• Critical review of findings from DSEN-funded research studies in working towards contributing to Health Canada drug regulatory and/or policy development, decision-making activities (HPFB).
• Ongoing discussions sessions between Health Canada staff and DSEN researchers to reframe query wording and discuss methodologies.  This engagement fosters communication and understanding between both parties on DSEN capability and the needs of the regulator.  Ultimately this will improve how Health Canada can leverage DSEN capacity (HPFB).
• Exchange of information on DSEN development and Health Canada research queries with the European Medicines Agency (HPFB).
• Engagement with international partners implementing related initiatives (e.g., EnCepp in EU; Sentinel in U.S.) to share best practices and explore opportunities for data sharing (HPFB).
• Support of DSEN Steering Committee representatives (e.g., preparation of briefing material, etc.) (SPB and HPFB).
• Active participant in CIHR-led DSEN activities (SPB and HPFB).
• Active contributor and participant in DSEN's annual Knowledge Translation meeting, to develop the guiding principles of transparency within DSEN, and for communicating DSEN findings (HPFB and SPB).
• Active participation in the semi-annual DSEN Network operational meetings, which brings together DSEN decision makers and researchers to advance their working relationships (SPB and HPFB).

Performance Indicators: Year over year increase in PSUR submitted by industry and year over year increase in Adverse Reaction Reports submitted by Institutions. Also tracked are # of patients/consumers recruited; # of patients/consumers trained, # of patients/consumers who have taken part in consultations, patient/consumer satisfaction; and client (HPFB) satisfaction.

HC 17.2 b Expected results for 2012-13 (Targeted Oversight for Consumer Product Safety):

Through targeted oversight actions, the Consumer Product Safety program activity works to detect safety problems as early as possible and at all stages in a product's life cycle. Under the new CPSA, Consumer Products Safety program has improved authorities to ensure investigative actions are being taken to determine the safety profile of products and to verify that preventative measures are being implemented.

Expected Results: Improved information and reporting of consumer product safety related incidents (by industry and consumers).

HC 18.2 b Results Achieved in 2012-13 (Targeted Oversight for Consumer Product Safety):

CPS received 2,645 new incident reports from consumers and industry including 483 incidents reports with injuries in 2012-13. CPS continued to conduct risk assessments (with over 100 risk assessments reports completed (such as formaldehyde, magnet sets and evidence of safety reviews) and over 500 cases underwent risk assessment analysis.

Type of injury/illness
CPS received 483 new incidents reports with injuries in 2012-13. Incident type breakdown is:

• 26 incident type cases with reported deaths.
• 68 incident type cases with reported serious injuries.
• 389 incident type cases with reported injuries.

Increased sharing of information with international regulators:

Internationally, key 2012-13 highlights include implementation of the North American Cooperative Engagement Framework and preparations for the Second North American Summit to be held in Ottawa, in September 2013. The North American Cooperative Engagement Framework supports greater cooperation for the sharing of information on consumer products that could present a hazard to human health and safety. Activities under the Action Plan with China's General Administration of Quality Supervision, Inspection and Quarantine (AQSIQ) included: successful completion of the pilot for the Urgent Consultation Mechanism on lighters, toys and textiles; meetings with Chinese Academy of Inspection and Quarantine (CAIQ) and China Inspection and Quarantine (CIQ) for information exchange on testing and inspection; presentations to Chinese manufacturers on Canadian consumer product safety requirements; and initiation of plans for the Canada-China CPS High Level Dialogue Meeting tentatively targeted for Fall 2013.  In October 2012, CPS supported the launch of the OECD Global Recalls portal, which pools product recall information from various countries.

Provide ongoing scientific support and advice in the areas of EMF, Noise and Electro-optics to the:

1. World Health Organization (WHO):
   • Participate on WHO EMF Project Working Group to develop the Environmental Health Criteria document on RF fields.
   • Input provided into a WHO survey of national practices for RF regulations completed.
2. American National Standards Institute (ANSI):
   • Provided review and comments on draft ANSI Noise Standard.
3. International Commission on Illumination (CIE):
   • Responded to a CIE technical report on "Sensitivity of human skin to UV radiation".

Participation in meetings on international standards for non-ionizing radiation emitting devices (e.g., noisy machinery, ultraviolet, lasers, microwave, radiofrequency and ultrasound)

1. Canadian Standards Association Technical Standards Committee Z-386:
   • Provided input, based on international standards on Safe Use of Lasers in Health Care Facilities.
2. InternationalOrganization for Standardization (ISO):
   • Attended ISO working group meeting for machinery noise and provided comments on standard.

As well, drafted sections for Canadian Acoustical Association Guidelines on use of international standards in Canada.

In support of developing international standards for medical imaging equipment participated in:

1. International Electrotechnical Commission (IEC):
Participated in review of IEC committee draft on mammography to address the inclusion of tomosynthesis equipment.

Performance Indicators: # of health-related consumer product incidents reported including type of injury/illness and product category examined (i.e., Consumer Products, Cosmetics) that cause illness/risk; # complaints received; # advisories and warnings issued; and # product recalls issued/recall monitoring/recall effectiveness.

The Food Safety & Nutrition program activity has no targeted oversight funding under this initiative.

Rapid Response

HC 17.2 c Expected results for 2012-13 (Rapid Response for Consumer Product Safety):

Expected results: Improved industry compliance* with product safety obligations.

*Compliance is measured by a monitoring approach.  Compliance results are determined by monitoring activities following initial inspection. Due to the non-license (post-market) nature of the consumer products industry, compliance verification is limited to primary level establishments and targeted to the highest levels of trade.

HC 18.2 c Results Achieved in 2012-13 (for Consumer Product Safety):

When there is a concern with a product, consumers are informed quickly through risk communications posted on the Health Canada website, such as consumer product recalls and advisories. Recalls are used when industry or Health Canada become aware of a danger associated with a consumer product, and consumers need to be made aware so that they can stop using the product in its current form. Some recalls involve consumers disposing of the product or returning it to the place of purchase for a refund. Other recalls involve consumers contacting the manufacturer for a repair kit, replacement, or updated user instructions. In all cases, a recall involves some action being taken by both industry (remove the unsafe product from the market and/or correct it, if possible) and consumers (stop using the unsafe product in its current form). Advisories are generally used to help educate consumers about potential health risks associated with the unsafe use of a consumer product. For example, during 2012-13, Health Canada used social media to inform Canadians of the 29 advisories and 236 recalls issued related to consumer products. These advisories and recalls were the result of various activities including: planned compliance and enforcement activities; mandatory incident reports from industry; voluntary incident reports from consumers and information sharing with other jurisdictions such as the United States.

The regulatory regime for the Consumer Product Safety Program is based on Post-Market Surveillance. Under the Cyclical Enforcement Cycle, the sampling for compliance is targeted to those regulated product categories where there is a reasonable assumption of non-compliance (i.e. higher risk). Therefore, high rates of non-compliance are expected. This is an indicator that the risk-based sampling is effective.

Consumer Product Safety Program officials continued to conduct cyclical enforcement activities for 2012-13. Corrective action was taken on one-hundred percent (100 %) of non-compliant products inspected as identified through the targeted cyclical enforcement plan.

Completed in 2012-13, was the cyclical targeting of 10 regulated product categories with identified hazards and baseline data:

• Halloween Costumes: 47 samples - 21% non-compliant -  10 recall notices issued.
• Children's Jewellery: 119 samples - 11% non-compliant - 13 recall notices issued.
• Cosmetics-face paints: 48 colours on 29 products tested - 7% non-compliant - 1 recall notice issued.
• Toys (Noise): 20 samples - 5% non-compliant - 1 recall notice issued.
• Cosmetics - Formaldehyde: 31 hair smoothing products tested - 3% non-compliant - 1 stop sale issued.
• Cribs, Cradles and Bassinets: 25 samples - 100% non-compliant - 1 recall notice issued; violations include: assembly/labelling, bounded openings, shearing/pinching, side height.
• Kettles: 23 samples - 4% non-compliant - 1 recall notice issued.
• Lighters: 18 samples - 67% non-compliant - 4 recall notices issued.
• Candles: 334 inspections. 3.9% non-compliant.  1 recall notice issued.
• Restraint systems - car seats: Products examined at 37 retailers and 15 manufactures contacted for a list of products.  One (1) product (unknown # of individual seats) non-compliant. Voluntary removal of product.

In support of modernizing the Radiation Emitting Devices Act (REDA), the administrative function of REDA was strengthened through the development of seven Compliance and Enforcement Standard Operating Procedures (SOPs) for nine regulated products under REDA. These SOPs are used by inspectors when conducting an assessment of a radiation emitting device under REDA and regulations.

Ninety-five (95) assessments related to education about and the enforcement of the Radiation Emitting Devices Act (REDA) and regulations were completed in 2012-13.

Performance Indicators: % and # of inspected registrants/firms/users that are compliant** ('C') / non-compliant ('NC') with standards/acts/regulations /guidelines including Consumer Product Safety Regulations and cyclical enforcement (Product Category).

**Compliance is measured by a monitoring approach. Compliance results are determined by monitoring activities following initial inspection. Due to the non-license (post-market) nature of the consumer products industry, compliance verification is limited to primary level establishments and targeted to the highest levels of trade.

HC 17.3 c Expected results for 2012-13 (Rapid Response for PMRA):

PMRA enhances compliance targeting and enforcement capacity in support of expanded regulatory authority under the PCPA, and maintains public confidence in pesticide product safety. In conjunction with other federal and provincial regulators, Health Canada continues the development and implementation of an evidence and risk-based approach to identify and act on situations of higher risk associated with non-compliance. Activities continue to include the enhancement of current information/intelligence networks, analysis and an updated targeting strategy to verify the presence of compliance and the reasons that non-compliance was found to exist. Activities also include an updated strategy to address the importation of unregistered consumer pesticides where the safety would be unknown.

Expected results: Improved risk-based monitoring of products.

HC 18.3 c Results Achieved in 2012-13 (Rapid Response for PMRA):

PMRA undertook several initiatives to monitor and enforce industry compliance with the Pest Control Products Act. PMRA implemented a compliance verification program for consumer product vendors. It also introduced a compliance verification program targeting vendors of unregistered international pest control products. Finally, it implemented a cyclical compliance monitoring program, which ensures that, within a five-year cycle, the Agency will have performed compliance monitoring activities for the full regulated community.com

Performance Indicators: # monitoring reports; #, % of targeted inspections on products/industries/sector of high risk to health; # follow-up inspections; and # and/or % pest management products monitored.

HC 17.4 a Expected results for 2012-13 (Active Prevention for Food Safety and Nutrition):

The Food Safety and Nutrition program activity will continue to support the Government as it develops and seeks Parliamentary approval for amendments to the Food and Drugs Act (FDA) to strengthen and modernize food safety provisions. The program will continue to conduct risk mapping exercises, engage industry to address food safety risks, develop strategic partnerships for work sharing opportunities in standard setting with international food regulators, consult with consumers and industry on updated food standards and will update its health risk assessment standard operating procedures to respond to new service standards.

Expected Results: Increased industry and public understanding/engagement in food safety risks and mitigation processes, improved international collaboration in establishing global standards and establishment of the appropriate instrument or mix of instruments, including regulatory and non-regulatory measures (policies, standards, etc.), to address immediate areas of concern.

HC 18.4 a - Results Achieved in 2012-13 (Active Prevention for Food Safety and Nutrition):

As part of Bill C-38, the Jobs, Growth and Prosperity Act, the Minister of Health was provided with new authorities under the Food and Drugs Act that included the ability to enact Marketing Authorizations (MA) and a broader ability to incorporate documents by reference (IbR).  Health Canada has used these new authorities to reset the regulatory system for food additives by enacting fifteen food additive MAs which incorporate by reference fifteen lists of permitted food additives.

Health Canada continued to assess the prevalence and persistence of various foodborne pathogens on fresh produce (i.e., Campylobacter, Cryptosporidium, Cyclospora, Giardia, Escherichia coli O157, Listeria monocytogenes, Noroviruses, Salmonella), raw foods of animal origin (i.e., Campylobacter, E. coli, Clostridium botulinum, Clostridium difficile, Cryptosporidium, Giardia) and seafood (i.e., L. monocytogenes,  Cryptosporidium, Giardia, Vibrio species, Norovirus, Hepatitis A).

Health Canada consulted with stakeholders in December 2012 to gather scientific data and information on E. coli O157 in Mechanically Tenderized Raw Beef Products. The feedback received from this consultation supported Health Canada's risk assessment and scientific investigation addressing issues pertaining to tenderized raw beef products produced and consumed in Canada.

In August 2012, Health Canada met with regional stakeholders with expertise in the production of soft and semi-soft raw milk cheese made from unpasteurized milk to seek their input on the proposed new requirements. Feedback was sought regarding the validity, utility and feasibility of the proposed microbiological criteria, their potential impact on Industry, and whether additional policy elements should be considered. Health Canada intends to further consult with stakeholders to obtain information regarding consumers' handling and consumption in order to better inform consumers regarding the safety of these products.

Health Canada developed guidance in support of the publication of the new food allergen labelling requirements for specific priority allergens, gluten sources and added sulphites in prepackaged food in Canada.  This guidance was developed in consultation with stakeholders, including allergy associations and the medical community.  These new food allergen labelling regulations came into force in August 2012.

Health Canada organized a stakeholder workshop to fully characterise the adventitious presence of soy as an allergen in wheat based-foods. Health Canada initiated a two year process to gather information and data necessary to fully evaluate the issue of soy in wheat and develop standards and guidance for industry regarding appropriate labelling.  In January, advice to Canadians with soy allergy was published.

Surveys to support activities as they relate to Food Allergens were completed.  These include a large market basket of inherently gluten-free flours (rice, corn, etc.) to determine cross contamination with celiac gluten sources. This work supports the education of Canadians with celiac disease and supports risk assessment towards the use of CODEX limits for gluten-free foods for Canadians. Another survey for soy and mustard allergens in cereal grains was completed to investigate the risk of cross contamination in the grain supply chain. This work has resulted in one accepted publication and two that are pending.  Various method development initiatives for food allergens and gluten were carried out to support industry in their quality control and compliance efforts.

In February 2013, Health Canada signed a Letter of Agreement with the Canada Agriculture Museum confirming its participation as a major level sponsor of the Food: The Science You Eat (working title) initiative to be launched in December 2013. This new food science initiative will include a 2000 square foot exhibition in Canada's capital, a national travelling exhibition, extensive public programming which will feature health and nutrition topics; daily demonstrations on food science and food safety; special events with food and nutrition topics; and a guest speaker series to engage the tens of thousands of school children as well as adult and senior visitors that visit the Museum for educational programs every year.

Guidance Documents/Publications:

The following Guidance Documents/Publications were issued or developed in support of Active Prevention for Food and Nutrition Safety:

• In preparation of the regulatory amendments coming into force to enhance the required labelling for food allergens, gluten sources and added sulphites, the Food Safety and Nutrition program published a position on the labelling requirements of vintage wines and fining agents as well as its position on refined oils and allergen labelling.
• HC's guidance on gluten-free claims.
• The Botulism Guide for Healthcare Professionals, which provides guidance to stakeholders dealing with suspected botulism cases in Canada.
• On October 4 2012, Health Canada published a Summary of Comments Received as part of Health Canada's 2010 Call for Data on Ochratoxin A (OTA). From August 6th to December 31st 2010, Health Canada conducted an open call for new OTA occurrence data. The main goal of this call for data was to obtain information to assist in identifying priorities for the development of risk management strategies related to this natural toxin. The present document provides a summary of the comments received. Upon the review of additional OTA occurrence data and other relevant information, Health Canada will finalize a decision regarding the risk management approach for OTA in foods
• Consulted on Health Canada's Guidance Document: Draft Guidance for Industry on Novelty Determination of High Pressure Processing (HPP)-Treated Food Products. This document enables food manufacturers to determine whether their HPP-treated product requires a safety assessment by Health Canada, as set out in Division B.28 of the Food and Drug Regulations.
• Finalized the guidance document entitled Guidance for Industry on Reducing the Risk of Salmonella Enteritidis in Canadian Shell Eggs. This guidance document was developed to provide industry with recommendations on ways to reduce the risk of foodborne illness due to Salmonella Enteritidis in shell eggs.
• Finalized draft guidance for industry on safe cooking and handling labelling of raw ground meat and poultry. Health Canada plans to consult the food industry in 2013 about current practices regarding their use of these labels on packages of raw ground meat and poultry, as well as to receive feedback on the guidance document.
• Developed a health risk opinion to assist the CFIA in determining appropriate compliance and enforcement action should non-O157 serotypes of E. coli be identified in tested lots of Canadian beef trim destined for the U.S.
• Developed updated guidelines for Diarrhoeic Shellfish Poisoning (DSP) toxins in shellfish.

International Collaboration
Health Canada continues to lead and leverage food standard development and risk management standards based on an internationally recognized system (Codex).  Canada hosted the 40th session of the Codex Committee on Food Labelling (CCFL) in May 2012.  The Committee agreed to advance several items related to the Implementation of the WHO Global Strategy on Diet, Physical Activity and Health to the 35th Session of the Codex Alimentarius Commission for adoption.

In July 2012, the 35th Session of the Codex Alimentarius Commission was held and Commission adopted over 30 standards, guidelines and codes of practice intended for voluntary application by governments. Standards adopted that are of particular interest to Health Canada and on which Health Canada provided significant input, include: revisions to the risk analysis principles applied by the Committees on Food Hygiene, Additives and Contaminants; Maximum Level (ML) for melamine in liquid infant formula; Maximum Residue Levels (MRLs) for ractopamine; definition for nutrient reference values; and revision of the Guidelines for Use of Nutrition and Health Claims concerning a new definition for "non-addition claim", conditions for free of salt claims, amendments to the section on comparative claims and conditions for non-addition of sugars claims.

Health Canada co-lead the Electronic Codex working group in preparation for the Codex Committee on Contaminants in Food to finalize maximum limits for DON in cereal and cereal derived foods.

In addition, Health Canada took part in the 44th session of Codex Committee on Food Hygiene (CCFH) which develops international guidance with respect to food hygiene for all foods, including the consideration of risk management matters in relation to food hygiene.

Performance Indicators: # of engagement opportunities with industry, international collaborations; # of guidance/educational tools developed; # of standards, frameworks and policies developed or modified; and # of consultations/engagement activities with Canadians and target populations.

HC 17.4 c Expected results for 2012-13 (Rapid Response for Food Safety and Nutrition):

Under the rapid response pillar the Food Safety and Nutrition program activity will continue its participation in the Partnership for Consumer Food Safety Education with the goal of promoting the "Be Food Safe" campaign and will continue to develop new education materials for consumers to promote food safety in an effort to reduce foodborne disease outbreaks in Canada. In addition, it will develop a strategy for addressing the findings of a Public Opinion Research in February 2010 that measured the percentage of population aware of and engaged in food safety risks, alert systems and safety systems.

Expected Results: Increased public understanding of food safety risks, alerts systems and safety systems.

HC 18.4 c Results Achieved in 2012-13 (Rapid Response for Food Safety and Nutrition):

Targeted Consumer Risk Communication
The Food Safety and Nutrition program continued with its participation in the Partnership for Consumer Food Safety Education with the goal of promoting the "Be Food Safe" campaign.  The program also continued to develop new education materials for consumers to promote food safety in an effort to reduce foodborne disease outbreaks in Canada.

Be Food Safe Campaign

Health Canada provided expertise, financial support, maintained and distributed education materials for the "Be Food Safe" campaign. Health Canada assisted in the updating of the Be Food Safe Website.  The Department continued to improve the consolidation and tracking of data through the public inquiries centre and managed a central contact centre for consumer phone and e-mail requests for information on food and product safety issues. A regular communications calendar was also maintained. Information Updates and food safety tips sheets were created and updated on a regular basis (i.e., Information Updates on BBQ season, Summer food safety; Shellfish Food Safety Tip Sheet, Thanksgiving Food Safety Tip Sheet, Home Canning Tips Sheet and Halloween Food Safety Tips Sheet to name a few) along with periodic posting of safety messages on social media websites such as Facebook and Twitter.  The Department also addressed media requests for interviews on subjects that are posted on both websites.

A total of 489,456 safe food handling web pages (English and French) were viewed in 2012-13 (97,852 on Healthy Canadians and 391,604 on Health Canada).

Performance Indicators: % of targeted population aware, engaged in food safety risks, alert systems and safety systems; and # of web hits of consumer oriented web pages.

Canadian Food Inspection Agency (CFIA)

Active Prevention

CFIA 17.1 a Expected Results for 2012-13 (Active Prevention):

The CFIA food safety initiatives aimed at ensuring active prevention include measures to enable government to better understand and identify food safety risks and to work with industry to implement effective food safety risk mitigation strategies. The CFIA, along with its federal partners, will strive to strengthen food safety standards and regulations and will engage Canadians in making decisions with respect to food safety.

In 2012-13, the CFIA will continue to support the Government as it develops and seeks Parliamentary approval for amendments to food safety legislation, and will move forward with its Imported Food Sector Product Regulations regulatory proposal under the Canada Agricultural Products Act.

The CFIA will continue to work with Health Canada on data collection and risk mapping towards identification and characterization of areas of concern, including imported food ingredients, produce, mycotoxins in cereals and undeclared allergens. Risk mapping will identify gaps in standard-setting and policy development and will assist in focusing operational efforts on areas of greatest risk.  Data collected through baseline surveillance will serve to fill information gaps.

The CFIA will continue engagement with counterparts in other countries to enhance food safety information exchange and identify best practices to inform risk management approaches.

The CFIA will continue to revise its food safety programming for verification of industry food safety systems in high-risk sectors and IM/IT business solutions for supporting importer licensing will be further developed.  As well, the CFIA will also continue to inform consumers and industry on the Canadian Food Labelling Initiative and the use of Product of Canada and Made in Canada claims on food products.

Expected results: To better identify, assess, and prioritize potential food safety hazards through risk mapping, information gathering, and sampling and testing of foods on the Canadian marketplace and to inform the relevant Agency stakeholders on relative risk in order to influence decisions and priorities for different food/hazard combinations; improved industry compliance; industry implementation of preventive food safety systems; establishment of standards, regulations, and policies that contribute to the prevention of food safety issues through the product lifecycle.

CFIA 18.1 a Results Achieved in 2012-13 (Active Prevention):

Food safety risk scanning, prioritization, and profiling processes were finalized and endorsed by the Agency's Food Business Line. Progress in this area included expanding the list of food hazard combinations to be included for risk ranking.  These activities contribute to the Agency's risk mapping capability and enabled the identification of gaps in food safety controls and potential intervention points in the farm to fork continuum.

One risk profile, which is a compilation of scientific information on a specific food hazard combination, was completed for E.coli in spinach.

The CFIA conducted eighty-six (86) targeted surveys for microbiological and chemical hazards: allergens (7), bacteriology (56), and chemistry (23).

The analysis of results for compliance of microbial targeted surveys conducted in Years 2 and 3 of the FCSAP were compiled into six (6) commodity groups for reporting. The analysis of compliance results for chemistry targeted surveys conducted in 2010-11 were compiled into ten (10) summary reports, and the analysis of results for compliance of allergen targeted surveys conducted in Years 3 and 4 of the FSCAP were compiled into ten (10) summary reports.

Although delays occurred with the publication of the proposed Imported Food Sector Product Regulations, a Notice of Intent on the regulatory proposal and the associated User Fee was published in CGI, and significant progress was made on the re-designed program and associated policies for compliance verification.  Pilots on both the compliance verification (CV) approach and the web-based license management system (LMS) to support the proposed regulations were conducted to identify issues prior to roll-out.  In conjunction with these pilots and regulatory development, industry was engaged to assess the potential impacts of the associated requirements on business operations.  The successful completion of the LMS pilot demonstrated the CFIA readiness for project implementation and facilitated Treasury Board granting authority to complete the preparation of the LMS for public release.

After delays since 2008, the CFIA established the legislative underpinning to support increase food safety system rigour when the Safe Food for Canadians Act received Royal Assent in November 2012.

A summary report was completed on the 2011-12 Packer / Re-packer of Fresh Herbs, Green Onions and Leafy Vegetable Establishment Inspection Pilot Project, which informed the continuing modernization of the Fresh Fruit & Vegetables Program.

The CFIA continued to engage with regulatory counterparts in QUAD governments (US, Australia, & New Zealand) on food safety to enhance regulatory cooperation and information exchange, as well as with counterparts in other governments (e.g. China, Mexico, Guatemala, India) to advance relationship building on food safety.  The CFIA also continued its participation in Codex Working Groups, including review and development of the Codex Annexes on melons and berries.

A joint review was conducted with Health Canada of Guatemala's food safety system and controls to prevent contamination of raspberries and blackberries. Completion of the review informed a revision to the import requirements for fresh Guatemalan raspberries and blackberries, communication with the industry, and development of a sampling plan for testing Guatemalan blackberries to be implemented in fiscal year 2013-14.

In furthering the Canadian Food Labelling Modernization, the Product of Canada guidelines provide consumers with information that help them make informed purchasing decisions, help industry comply with the requirements for making truthful and accurate claims, and provide the CFIA with the tools necessary to promote compliance in the market place.  In this regard, the CFIA updated Product of Canada information on its website and conducted twelve (12) labelling investigations related to Product of Canada, while continuing to monitor compliance with the guidelines through its inspection and label verification activities and responding to inquiries, complaints and referrals related to the interpretation and implementation of the revised policy.

Performance indicators: # of planned and % completed commodity / hazard targeted surveys to address information gaps; # of risk profiles completed; % completion of re-engineered risk prioritization, profiling, and mapping approaches; # of consultations held with industry and other jurisdictions; % completion of revised approaches to food safety system verification; # of inquiries related to Product of Canada guidelines; % completion of the supporting IM/IT infrastructure and tool for importer licensing management

Targeted Oversight

CFIA 17.1 b Expected Results for 2012-13 (Targeted Oversight):

In 2012-13, the CFIA will continue to adapt its food safety inspection practices for high-risk sectors. Evaluation and verification of industry's food safety control systems in both fresh fruit and vegetable, and non-federally registered sectors will take place with a focus on imported products. Method development and testing in targeted areas will continue, and front-line capacity will continue to increase. Border blitzes will be conducted, and IM/IT business solutions for supporting enhanced tracking of imported food products will be further developed.

Expected results: Improved industry compliance with food safety standards; modern tools and new risk-based approaches contribute to improved safety of imported foods.

CFIA 18.1 b Results achieved in 2012-13 (Targeted Oversight):

In the non-federally registered sector, a total of 382 inspections were conducted in the four identified priority areas of greatest risk (produce, mycotoxins in cereal, imported ingredients, undeclared allergens): 36 related to undeclared allergens and Salmonella spp. in chocolate and chocolate products; 33 related to microbial pathogens in minimally processed RTE fresh-cut fruits and vegetables; 5 related to deoxynivalenol (DON), ochratoxin A (OTA), and undeclared allergens in grain-based infant and toddler foods; 89 related to microbial pathogens, patulin, undeclared allergens in juice and juice products that fall under the jurisdiction of the Imported and Manufactured Food Program; 43 related to Salmonella and aflatoxin in imported peanuts, domestic and imported peanut butter, and domestic and imported tree nuts that fall under the jurisdiction of the Imported and Manufactured Food Program; 89 related to pathogens in spices, spice blends and seasoning mixes that fall under the jurisdiction of the Imported and Manufactured Food Program; and 33 related to microbial pathogens for sprouted seeds.  Additionally, 168 inspections were conducted as part of the Imported and Manufactured Food Program's Compliance Verification System Pilot Project in 2012-13.

In 2012-13, the CFIA completed Phase 9 and 10 of the eleven phase initiative for enhancements to the Automated Import Reference System database, which improves the availability of the information the CFIA uses to identify and track food products.

The CFIA continued monitoring of the requirements for importing Mexican cantaloupes into Canada, which are certified by the Mexican government (i.e. SENASICA) under the Cantaloupe Certification Program.

The CFIA conducted 69 Border Blitz inspections and 550 import surveillance activities in continuing targeted oversight of imported products.

IM/IT infrastructure to support the LMS and import tracking enhancements were completed as part of the LMS pilot.

In support of the Government of Canada's Beyond the Border Initiative, the CFIA and the Canada Border Services Agency (CBSA) collaborated on a pilot study to explore the feasibility of allowing a client of the CBSA's Customs Self-Assessment (CSA) Program to clear import shipments of non-federally registered sector (NFRS) products originating in the USA though the CSA process.  Analysis of next steps is still underway.

Performance indicators:  # and % of planned high-risk food safety inspections and verifications completed; # of border blitzes conducted; % completion of the supporting IM/IT infrastructure and enhancements to tools for import tracking; # required and % in place of new hires to support increased import tracking and enhanced inspection / verification activities; # and % of new testing methodologies developed and implemented.

Rapid Response

CFIA 17.1 c Expected Results for 2012-13 (Rapid Response):

Towards ensuring rapid response to food safety issues and emergencies, enhanced recall capacity will enable the Government of Canada to effectively respond to and conduct investigations for an anticipated increased number of food recalls resulting from targeted oversight activities. Targeted consumer risk communication activities and products will also enable consumers to make informed decisions about food safety by increasing awareness and understanding of the food production and inspection systems in Canada and increased consumer understanding of food safety risks and the required mitigating actions as well as the various roles and responsibilities within the food safety system, including those of the CFIA.

In 2012-13, the CFIA will continue to augment human resource capacity to address identified food safety issues. Enhancements to food safety recall and investigation methodology will continue.

Expected results: Timely and efficient recall capacity in the face of increased identification of potential risks through targeted testing and other information; better public understanding of food risks; increased consumer use of various food safety alert systems; and increased public trust and confidence in the food safety system.

CFIA 18.1 c Results achieved in 2012-13 (Rapid Response):

By the end of 2012-13, the CFIA managed more than 250 food recall incidents related to non-federally registered and fresh fruit and vegetable products, which resulted in over 500 secondary recalls.

Regarding recalls, the CFIA responded to more than 2600 web-based enquiries while Service Canada received more than 4800 requests for information.

Related to the CFIA's continuous efforts to enhance its food safety recall and investigation methodology, training materials for revised procedures were completed and will be delivered to trainers in the upcoming year in preparation for roll-out to inspectors. A Food Safety Risk Communications Strategy was developed and implemented in 2012-13. Activities under the Strategy provided audiences, including consumers, media and parliamentarians, with relevant, easy to understand information, in multiple formats. This included specific processing and inspection process as well as the food safety investigation and recall process. Furthermore, the Strategy integrated risk communication principles and practices into core CFIA food safety messages, and enhanced the effectiveness of recall communication products and activities.

In addition, the CFIA continued meetings of the Consumer Association Roundtable to ensure that consumers have a voice in the food safety continuum.

Forty (40) targeted surveys reports, from various fiscal years, were posted to the CFIA's website.  These reports present information on the findings of CFIA's targeted surveys regarding the occurrence of contaminants in the food supply.  These included seven (7) related to allergens, twenty-one (21) related to chemistry, and twelve (12) related to microbiology.  Additionally, the 2008-09 NCEMP Annual Report and the 2009-10 Pesticide and Residues in Fresh Fruit & Vegetable Survey were posted to the CFIA website.

Past food safety issues have highlighted the importance of gathering regular feedback from Canadians on food safety, food recalls and confidence in Canada's food safety system. Results have helped inform outreach initiatives and policies related to food safety.  They also provide the Agency with a better understanding of consumers' awareness, attitudes and behaviours in terms of food safety, and helps ensure communications material is consistent with the needs of Canadians.

Public opinion research conducted early in 2013 shows that Canadians remain moderately to extremely confident in Canada's food safety system (90% in 2013, 90% in 2012).  Almost nine in ten have heard of the CFIA (88%).  Three in four Canadians (75%) have heard about food safety or recalls in Canada in the past six months. Those who had heard of CFIA (78%) were much more likely to have heard about food safety or recalls in the past six months than those who were unaware of CFIA (48%).  However, Canadians continue to have an increased appetite for more information on food safety, particularly food recalls.  Results also indicate that Canadians hold a favourable opinion of the work done by the CFIA.

Performance indicators: # of personnel trained and available to support recall activities; # of recalls  and % conducted in accordance with CFIA standards; # of and % of required investigations conducted in accordance with CFIA standards; # of communications initiatives aimed at increasing consumer awareness of food safety issues and recall; % of consumers aware of food safety issues.

Active Prevention

PHAC 17.1 a Expected Results for 2012-13 (Active Prevention):

The Public Health Agency of Canada will modernize and strengthen Canada's food safety systems by using molecular typing, expanding the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) and C-EnterNet surveillance infrastructures, using decision making models in priority areas (e.g., Campylobacter, Salmonella and E. coli) and disseminating outbreak investigation results to provincial and territorial partners through the web-based Outbreak Summaries system.

Expected results: Increased understanding of food safety risks by the Public Health Agency of Canada, HC, and CFIA.

PHAC 18.1 a Results Achieved in 2012-13 (Active Prevention):

In order to better identify and understand food safety risks, the Public Health Agency of Canada is engaged in several activities, including surveillance, sharing of outbreak information, detection technologies, and development of risk assessment tools.  Significant achievements to date include the following:

Surveillance
FCSAP funding has maintained and enhanced the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) and the National Integrated Pathogen Surveillance Program (C-EnterNet) surveillance programs.  These programs consistently contribute valuable population-based information not available from any other sources on food-borne and gastrointestinal pathogens, and antimicrobial resistance in the food chain.  Data from both these programs have been accessed to look for potential sources in provincial and national food-borne illness outbreaks.

C-EnterNet operated in two sentinel sites in 2012-13.  Key achievements included:

• An analysis of parasitic enteric illness cases was published, providing important information in support of source attribution.
• Results from testing for parasites on bagged leafy greens were published to provide guidance for food safety activities.
• New information on the occurrence of enteric pathogens, such as Listeria, Giardia and Cryptosporidium, in imported herbs was generated.
• Bagged leafy greens sampling was re-initiated in 2013, to determine if issues identified in 2010 were addressed.
• Analysis of domestically acquired food-borne disease data was continued to provide information on sources related to gastrointestinal disease in Canada.

CIPARS achievements related to FCSAP funding in 2012-13 included the following:

• Retail sampling continued in seven provinces.  Sampling included beef, pork, chicken, turkey, imported seafood and, in collaboration with CFIA, produce.
• Through retail chicken meat testing, CIPARS continued to monitor and communicate the impact of partial reintroduction of ceftiofur use in meat chicken hatching eggs.
• CIPARS similarly continued monitoring and communicating increases in the prevalence of Campylobacter resistant to fluoroquinolones in retail chicken meat.
• CIPARS retail meat data is being used in the drafting of a "Risk Profile of Ceftiofur-Resistant Salmonella Heidelberg of Poultry Origin", which is based on Codex Guidelines for Risk Analysis of Foodborne AMR.  The Risk Profile will show the current state of knowledge and the risk management options for ceftiofur-resistant Salmonella Heidelberg of Poultry Origin, and will be, in part, a pilot test of the implementation of the Codex Guidelines for Risk Analysis of Foodborne AMR in Canada.
• CIPARS retail data continues to be regularly used by Health Canada in conducting safety evaluations to authorize the sale of antimicrobials for animal use, including post-market safety assessments of certain antimicrobials.  This has resulted in label changes and a 2012 claim withdrawal of a particular use of an antimicrobial in a class considered very important to human medicine.
• In the first initiative of its kind globally, the results of a meta-analysis on antimicrobial use and resistance in aquaculture and ornamental fish were published in three papers, which will inform surveillance in aquaculture in Canada and with respect to imported seafood.

In addition, data from CIPARS and C-EnterNet were used together and in conjunction with data from other enteric pathogen surveillance programs (e.g., the National Enteric Surveillance Program) in two publications - one relating to One Health, and one relating to Salmonella Enteritidis.  This kind of integration will help improve our understanding of the exposure of Canadians to food-borne pathogens and antimicrobial resistant bacteria through retail foods.

Overall, there were 12 peer-reviewed publications relating to C-EnterNet, as well as six peer-related publications relating directly to CIPARS' FCSAP activities.  In addition, in 2012-13, the Agency produced the C-EnterNet 2011 annual short report, the CIPARS 2010 and 2011 annual short reports, as well as the CIPARS 2011 Q4 and 2012 Q1, Q2 and Q3 Quarterly Salmonella Reports.

Outbreak Summaries Application
The Public Health Agency of Canada is leading the development and implementation of a platform for summarizing outbreak information.  The Outbreak Summaries Application is a secure, web-based application for documenting and disseminating outbreak data in a standardized manner, which can then be used for monitoring trends in sources and risk factors, evaluating public health interventions, and informing risk assessments.  The application has been implemented in five provinces, as well as at the PHAC, and discussions are ongoing to have additional provinces and territories implement the application.  As of March 31, 2013, there are over 2100 outbreak summaries in the system.  The Agency is currently in the process of writing the first report of outbreak summaries data, covering outbreaks reported in the system from 2000 to 2012, which is scheduled to be completed by summer 2013.

Detection
The Public Health Agency of Canada has the capacity and continues to conduct molecular fingerprinting using Pulsed Field Gel Electrophoresis (PFGE) for Listeria, Salmonella spp., Shigella spp., E. coli O157:H7 and non-O157:H7 VTEC isolated by surveillance programs.  As noted in previous years, the Agency has also optimized and evaluated the effectiveness of next generation molecular typing methodology (Multilocus Variable Number Tandem Repeat Analysis (MLVA)).  In 2012-13, 76% of the submitted E. coli samples were tested with MLVA.  Additionally, MLVA training and certification were made available to federal, provincial, and territorial partners in 2012-13.  The Agency detected and evaluated 89 separate clusters of cases spanning two or more provinces, based on real-time molecular testing (62 clusters of Salmonella, 15 clusters of E. coli O157:H7, 7 clusters of Shigella, and 5 clusters of listeriosis), which enabled outbreak investigations to be initiated at the earliest possible stage.  Genomics (DNA sequencing and genetic mapping) has been used to develop novel laboratory fingerprinting methods for Salmonella Enteritidis and Campylobacter.  Testing for Campylobacter using these methods now occurs at two sentinel sites and is being integrated into the PulseNet network, which ultimately will lead to better support and more rapid identification of contaminated food sources.

Risk Assessment
Key 2012-13 activities included:

• A joint PHAC-HC risk assessment model was updated to determine risks to Canadians from consumption of E. coli O157 in mechanically tenderized beef.  The model was used to quantify the impact of specific interventions on risk.
• The effectiveness of various interventions against Salmonella spp. in poultry were evaluated using systematic reviews and meta-analysis.  Results were incorporated into a simulation model to determine the overall effectiveness of interventions on retail level contamination.
• A simulation model was developed for contamination spread in a ready-to-eat product specific to the Canadian distribution system.  The model provides insight into public health risks as a function of time and location to inform risk mitigation strategies related to recalls or targeted messaging.

As part of the Agency's risk assessment activities under the FCSAP, there were four peer-reviewed publications and six issue papers issued to departmental colleagues and stakeholders.

Performance Indicators: % of reports tracked, # of peer-reviewed publications, # of issue papers provided to departmental colleagues and stakeholders, and number of provinces and territories using the Outbreak Summaries system.

Targeted Oversight

PHAC 17.2 b Expected Results for 2012-13 (Targeted Oversight):

1. More and better data on accidents, injuries, illnesses and deaths due to consumer products.
2. Engagement of risk assessment stakeholders.

PHAC 18.2 b Results Achieved in 2012-13 (Targeted Oversight):

1. PHAC expanded the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) to two new hospitals, for a total of 17, and is extending this program to Nunavut.  The Agency started converting CHIRPP to an electronic format to provide timely information on children's injuries and risk factors.  An early warning system to monitor consumer product hazards was established, with early identification in 2012-13 of child ingestion of small magnets and button batteries as new hazards.  Working with the Traffic Injury Research Foundation and Safe Kids Canada, the Agency published the Injury in Review, 2012 Edition: Spotlight on Road and Transport Safety, which highlighted bicycle-related injuries and fatalities. Additionally, a risk assessment questionnaire was included in the Canadian Longitudinal Study on Aging to produce data examining the link between consumer products and seniors falls.
2. The Agency has engaged risk assessment stakeholders within the Federal and Provincial Governments as well as from academic and hospital settings to identify and prioritize areas to be addressed.  It has also helped raise the profile of consumer product injuries, including bunk beds and inflatable amusement structures, by co-authoring articles with Canadian experts.

Performance Indicators: # and type of databases created/improved against plan; # of cases of product- related injuries; risk assessments of consumer-related injuries; and # and type of data/reports from key stakeholders.

Canadian Institutes of Health Research (CIHR)

Targeted Oversight

CIHR 17.1 a Expected Results for 2012-13 (Targeted Oversight):

The Canadian Institutes of Health Research will make investments and focus efforts in advancing the Drug Safety and Effectiveness Network (DSEN) to increase the available evidence on drug safety and effectiveness to regulators, policy-makers, health care providers and patients and to increase capacity within Canada to undertake high-quality post-market research in this area.

Work will continue on engaging interested parties during the development of the Network, delivering on peer-reviewed funding opportunities for the initiative and responding to strategic direction received from the DSEN Steering Committee.

Expected results: Increased knowledge of post-market drug safety and effectiveness to inform decisions and increased capacity in Canada to address priority research on post-market drug safety and effectiveness.

CIHR 18.1 a Results achieved in 2012-13 (Targeted Oversight):

Also see: DSEN, Health Canada, Health Products, Targeted Oversight

DSEN further established processes and procedures to support a national network, comprised of more than 150 researchers across Canada focused on five distinct methodological areas, which has been established to develop new research evidence to fill knowledge gaps identified by decision makers within the Canadian health care system.

Furthermore, DSEN established standard processes to support the network's function and the activities of the DSEN Steering Committee, which is comprised of senior executives from federal and provincial governments and non-governmental organizations, and the practitioner and public communities.

DSEN launched funding opportunities to meet its principal objectives to both increase the availability of new evidence on post-market drugs' safety and effectiveness to decision makers and the capacity in Canada to conduct this research.  The total of DSEN's sponsored projects is 82 at year end, with firm commitments for an additional 8 starting in 2013-14.

In order to support research directly responding to decision makers' queries, DSEN provided funds through the newly developed Rapid Funding for DSEN Targeted Research funding tool, to cover the project costs of DSEN Research Teams responding to specific decision makers' queries. DSEN held three Rapid Funding competitions in 2012-13, funding nine projects for a total cost of $1.3 million over three years.

In order to support research capacity development in post-market drug safety and effectiveness DSEN invested $1.8 million over five years in the career development of six new investigators, starting in 2012-13.

Finally, starting in 2012-13, DSEN invested $1.2 M in additional funding over four fiscal years via competitions made open to the wider research community to support research relevant to its mandate.

The DSEN Coordinating Office (CO) held semi-annual network meetings to engender the collaboration necessary for optimal network operations.  The fall 2012 meeting brought decision makers, DSEN funded researchers, trainees, and New Investigators together to gain common understanding and to enhance Network functioning with respect to Knowledge Translation, while the spring 2013 meeting brought Network participants together to gain common understanding on the specific evidentiary needs arising from the Federal Drug Regulator.

Collaborating DSEN researchers continued work to respond to priorities on the DSEN research agenda and to disseminate their research results.  DSEN Research Teams (RTs) have reported results back to decision makers on seven DSEN Queries, including results on a class of drugs known as new oral anticoagulants.  A study by the DSEN funded Canadian Collaboration for Drug Safety, Effectiveness and Network Meta-Analysis informed the work of the Canadian Agency for Drugs and Technologies in Health under their Therapeutic Review and contributed to several key messages on their use in the treatment of Atrial Fibrillation. At the end of 2012-13, 20 DSEN Queries were under research by RTs, and 11 other DSEN Queries were under consideration by decision-makers within the Federal Drug Regulator or the federal/provincial/territorial drug plans and pending discussions on scientific feasibility and methodological approaches.

To support the dissemination of DSEN funded research results, DSEN held a Knowledge Translation workshop to confirm knowledge translation principles for network participants and began work to develop guidance and templates for their wider uptake across the health care system.

The DSEN CO created a Science Advisory Committee, which comes together on a regular basis to initiate dialogue on the development of new DSEN Queries, in order to: facilitate the formulation of queries by decision makers which are amenable to the methodologies of DSEN; for the identification of potential studies which decision makers might find relevant for posing to the DSEN CO; and to exchange knowledge to guide capacity development (e.g. methodology, data, personnel, etc.) within DSEN.

In collaboration with its program partners at HC, CIHR finalized an evaluation design report describing a review of the implementation phase of DSEN.  Work on the data collection began in December 2012.

Performance Indicators: Evidence of the dissemination of research knowledge to the target audience.

19. Comments on Variances:

HC - (Health Products):

As a result of the 2012 Federal Budget decisions, the activities performed by the Office of Consumer and Public Involvement (OCAPI) were reallocated within the Branch.  The inherent process to this decision required a structural change and the phasing out of the organization in time.  The surplus reflects actions towards achievement of this process.  Moving forward, the piloting of the Patient and Consumer Participation Pool (PCPP) will be carried out using existing Branch resources.

CIHR - Targeted Oversight

As outlined in the FCSAP DPR 2010-11, the priority for roll out of the DSEN grants program first focused on developing the DSEN network of collaborating researchers through 2010-12.  CIHR thus managed funding between the implementation years to align the DSEN budget with the DSEN mandate and objectives. In 2012-13, an additional $1.4M was available, via an internal budget re-allocation, within the DSEN budget for dispersion as research grants in this fiscal year, allowing DSEN to disburse a total of $8.7M in grants.

CFIA - Active Prevention, Targeted Oversight, Rapid Response

There were unplanned efficiencies during the fifth year of implementation of the FSAP IM/IT project.  These efficiencies came from the use of commercially available sub-components, Government of Canada standard solutions, and internal shared services and infrastructures.  In addition, delays in the finalizing the proposed Imported Food Sector Product Regulations delayed program refinement and impacted the timing for hiring and training of inspectors which all contributed to the under spending in the Targeted Oversight.  For Rapid Response the over expenditure is attributed to the misalignment of the original funding requirements the actual costs.

PHAC - Active Prevention

Staffing complexities as well as logistical delays in contracting affected the Agency's ability to expend its full funding authority.

20. Results achieved by non-federal partners (if applicable): N/A

21. Contact information:

Kendal Weber,
Director General,
Policy, Planning and International Affairs Directorate, Health Products and Food Branch, Health Canada
Telephone: 613-952-8149
e-mail: Kendal.Weber@hc-sc.gc.ca

1. Name of horizontal initiative: Early Childhood Development (ECD) and Early Learning and Child Care (ELCC)

2. Name of lead department(s):

Health Canada (HC)

3. Lead department PAA Program:

First Nations and Inuit Health Primary Health Care

4. Start date:

• ECD component - October 2002.
• Early Learning and Child Care (ELCC) component - December 2004.

5. End date:

• ECD component - ongoing.
• ELCC component - ongoing.

6. Total federal funding allocation (from start date to end date):

• ECD: $320M 2002-03 to 2006-07 ($60M in 2002-03 and $65M thereafter). Ongoing: $65M per year.
• ELCC: $45M 2005-06 to 2007-08 ($14.5M in 2005-06; $15.3M in 2006-07; $15.2M in 2007-08). Ongoing: $14M per year.

7. Description of the horizontal initiative (including funding agreement):

The goal of the Federal Strategy on Early Childhood Development for First Nations and Other Aboriginal Children, announced in October 2002, is to address the gap in life chances between Aboriginal and non-Aboriginal children. This initiative allocated $320M over the first five years which was shared by Health Canada, Human Resources and Skills Development Canada, Aboriginal Affairs and Northern Development Canada, and the Public Health Agency of Canada.

In December 2004, an additional $45M was approved (beginning fiscal year 2005-06) with $14M ongoing,  to increase access to and improve the quality of ELCC programming for First Nations children on reserve.

The objectives of these funds are to increase access to and improve the quality of ELCC programming for First Nations children on reserve, and improve integration and coordination between the two programs through joint planning, joint training and co-location.

8. Shared outcome(s):

The ECD component complements the September 2000 First Ministers F/P/T ECD Agreement. It seeks to address the gap in life chances between Aboriginal and non-Aboriginal children by improving the developmental opportunities to which Aboriginal children (and their families) are exposed at an early age (0-6 years).

The ELCC component complements funding released to provinces and territories under the March 2003 Multilateral Framework for Early Learning and Childcare (ELCC) to improve access to ELCC programs and services.

9. Governance structure(s):

• Interdepartmental ECD ADM Steering Committee;
• Interdepartmental ECD Working Group.

10. Performance highlights:

19. Comments on variances:

Early Childhood Development (ECD) Strategy for First Nations and Inuit Communities actual spending in 2012-13 was reduced in order to simplify and to streamline operations as a result of 2012 Deficit Reduction Action Plan decisions.

Electronic Link: For more information, please visit Aboriginal Head Start on Reserve and Fetal Alchohol Syndrom/Fetal Alcohol Effects.

10. Performance highlights:

19. Comments on variances:

The $2.15M Variance from Planned Spending to Actual Spending is due to program reductions, including government reductions in travel.

Electronic Link: For more information, visit  Aboriginal Head Start in Urban and Northern Communities (AHSUNC)

10. Performance highlights:

(*) Based on current HRSDC Program Activity Architecture.

10. Performance highlights:

19. Comments on variances:

Early Childhood Development (ECD) Strategy for First Nations and Inuit Communities actual spending in 2012-13 was reduced in order to simplify and to streamline operations as a result of 2012 Deficit Reduction Action Plan decisions.

20. Results to be achieved by non-federal partners (if applicable): N/A

21. Contact information:

Halina Cyr, Director
Health Promotion and Disease Prevention,
Inter-professional, Advisory and Program Support Directorate
First Nations and Inuit Health Branch, Health Canada
Postal Locator 1920A Tunney's Pasture, Ottawa
Telephone: (613) 948-6412
Email: halina.cyr@hc-sc.gc.ca

Internal Audits and Evaluation

Link to published report

Response to Parliamentary Committees and External Audits

Response to Parliamentary Committees is assigned to SPB.

2012 Spring Report of the Auditor General

Chapter 1--Border Controls on Commercial Imports

The overall objective of the audit was to determine whether the Canada Border Services Agency (CBSA), the Canadian Food Inspection Agency (CFIA), Health Canada, Natural Resources Canada (NRCan), and Transport Canada control, at the border, selected commercially imported products that pose a risk to the health and safety of Canadians.

Health Canada received two recommendations.  More information on this audit.

2012 Fall Report of the Auditor General

Chapter 1--Planning the Use of Professional Service Contractors

The objective of our audit was to determine whether selected departments adequately plan their use of professional service contractors.

Health Canada received three recommendations.  More information on this audit.

December 2012

The Office of the Commissioner of Official Languages completed a follow-up to assess the  implementation of the July 2007 audit recommendations and measure the four institutions' progress in providing direct bilingual health care services to their clientele.

Health Canada Evaluations (2012-13 Fiscal Year)

Response to Parliamentary Committees and External Audits

"Drug Supply in Canada: A Multi-Stakeholder Responsibility" - Report by the Standing Committee on Health was released June 8, 2012. The Government Response was tabled October 5, 2012.

The Committee Report and recommendations highlight the importance of all players working collaboratively in order to help safeguard nation-wide drug supply. The Report includes seven recommendations directed towards the Minister of Health. Two of these recommendations were directed solely at the federal government, including a proposed regulatory change that requires manufacturers to provide Health Canada advance notification of six months for planned discontinuances; and, for the Public Health Agency of Canada to develop a policy on the role of the National Emergency Stockpile System during shortages of essential medicines.

The remaining recommendations are directed towards collaborative work between the federal government and provinces and territories, as well as other key stakeholders, such as the Canadian Agency for Drugs and Technologies in Health (CADTH). These recommendations are focused on providing clinical information on therapeutic alternatives; identifying critical medicines with limited suppliers; improving the public reporting of supply disruptions; and, reviewing policies related to drug pricing, as well as tendering and contracting requirements with implications on drug supply.

The Government Response (GR) agreed in principle with the report and its recommendations, notably the need for a multi-stakeholder approach that acknowledges the distinct and collaborative roles and responsibilities of the various players involved in preventing and limiting the impact of drug shortages. The GR calls upon the Government of Canada to collaborate with the various stakeholders along the spectrum of the drug supply chain and highlights ongoing efforts to increase transparency and to clarify government policy during essential medicine shortages.

For further information, please visit:

 House of Commons Committees - HESA (41-1) - Drug Supply in Canada: A Multi-Stakeholder Responsibility

"Canada's Clinical Trial Infrastructure: A Prescription for Improved Access to New Medicines" - Report by the Standing Senate Committee on Social Affairs, Science and Technology was released November 1, 2012. The Government Response was tabled May 2, 2013.

As the first phase of a four-part study on pharmaceutical drugs in Canada, the Committee made twelve recommendations with respect to clinical trials that address issues such as:  enhanced leadership of the federal government; transparency of the clinical trial process; standards and accreditation of research ethics review; barriers to patient recruitment; inclusion of vulnerable sub-groups of the population; drugs for rare diseases; and, the need to assess patent protection and tax incentives.

The Government Response noted that Canada's clinical trial infrastructure includes a diverse group of stakeholders who strive to bring innovative therapies to patients. Promoting good research conduct and protecting patient safety are shared responsibilities between drug sponsors, the regulator, provinces and territories, the research community, and ethics review boards. Only through committed stakeholder collaboration will Canada be able to build a stronger and more internationally competitive clinical trial infrastructure that helps to introduce the latest health care innovations to patients, advance health outcomes, and ultimately improve the lives of Canadians.

For further information, please visit:

 Senate of Canada Committees - SOCI (41-1) - Canada's Clinical Trial Infrastructure: A Prescription for Improved Access to New Medicines

http://www.parl.gc.ca/Content/SEN/Committee/411/soci/rep/rep14GovResponse-e.pdf

"Chapter 4, Regulating Pharmaceutical Drugs - Health Canada, of the Fall 2011 Report of the Auditor General of Canada" - Report by the Standing Committee on Public Accounts was released on February 11, 2013. The Government Response was tabled on June 10, 2013.

The Committee's report contained one recommendation calling on Health Canada to provide the Committee with a detailed progress report on its June 1, 2012 action plan items. Health Canada provided this update as of March 31, 2013; it can be found on the  Committee's website.

For further information, please visit:

 House of Commons Committee - PACP (41-1) - Chapter 4, Regulating Pharmaceutical Drugs - Health Canada, of the Fall 2011 Report of the Auditor General of Canada

"Prescription Pharmaceuticals in Canada: Post-Approval Monitoring of Safety and Effectiveness" - Report by the Standing Senate Committee on Social Affairs, Science and Technology was released March 26, 2013. The Government Response was tabled June 26, 2013.

As the second phase of a four-part study on pharmaceutical drugs in Canada, the Committee made 19 recommendations on ways to enhance post-approval monitoring and to make it an integral part of the safety and effectiveness system.

The Government Response stated that Health Canada has worked diligently in recent years to improve what is already one of the best drug safety regulatory systems in the world.  The Department has done this through legislative and regulatory modernization, improvements to adverse drug reaction data collection, and enhanced transparency and communications. The Department stated that it will continue to improve its ability to monitor the safety of post-approval drugs so that appropriate action is taken to protect Canadian families.

For further information, please visit:

 Senate of Canada Committees - SOCI (41-1) - Prescription Pharmaceuticals in Canada: Post-Approval Monitoring of Safety and Effectiveness
http://www.parl.gc.ca/Content/SEN/Committee/411/soci/rep/rep20GovResponse-e.pdf

Respendable Revenue

Reflected in this table is the collection of respendable revenues by program activity and of non-respendable revenues.

Respendable revenues refers to funds collected for user fees or for the recovery of the cost of departmental services. These revenues include those both external and internal to the government, the majority being external.

A variety of respendable revenues are collected which include Medical Devices, Radiation Dosimetry, Drug Submission Evaluation, Veterinary Drugs, Pest Management Regulation, Product Safety, hospital revenues resulting from payments for services provided to First Nations and Inuit Health hospitals, which are covered under provincial or territorial plans, and for the sale of drugs and health services for First Nations communities.

User Fees

Health Canada

B. Date Last Modified:

C. Other Information:
Acronyms
NDS: New Drug Submission
C. Other Information:

i.Acronyms

NDS:

New Drug Submission

SNDS:

Supplement to a New Drug Submission

ANDS:

Abbreviated New Drug Submission

SANDS:

Supplement to an Abbreviated New Drug Submission

DIN:

Drug Identification Number Application

INDS:

Investigational New Drug Submission

ESC:

Experimental Studies Certificate

NC:

Notifiable Change

NAS:

New Active Substance

OTC:

Over the Counter

Rx:

Prescription

Clin:

Clinical

Comp:

Comparative Bio, Clinical or Pharmacodynamic Studies

C&M:

Chemistry and Manufacturing

N/A:  at time of reporting either no submissions of that type were received or no reviews of that submission type were completed, therefore no performance information available.

ii. Performance

As per the User Fee Act, when a department fails to meet its service standards by more than 10%, a fee reduction takes place upon tabling of the DPR.  They are in effect until the date of the next Departmental Performance Report.

Where a regulating authority's performance in a particular fiscal year in respect of a use fee does not meet the standards established by it for that fiscal year by a percentage greater than ten per cent, the UFA requires that the user fee be reduced.

When a service standard is missed, the fee is reduced by the percentage missed, up to a maximum of 50%. In 2012-13, for Pharmaceutical drug submission reviews, service standards were met for 30 of 35 lines.  However, three of the generic drug pharmaceutical lines did not meet the service standard, and will be assessed penalties.   They are:

1. COMPARATIVE STUDIES C&M / ANDS, with a target of 180 days, and performance of 264 days (penalty 47%).
2. COMPARATIVE STUDIES / C&M / SANDS, with a target of 180 days, and performance of 340 days (penalty 50%).
3. CHEMISTRY & MANUFACTURING /ANDS, with a target of 180 days, and performance of 233 days (penalty 29%).

Two additional lines did not meet the performance standard, but did not exceed the target by more than 10%, so there are no penalties incurred.  They are:

1. CLIN C&M/NDS - target of 300 days, performance was 302 days.
2. Chemistry & Manufacturing /SANDS- target of 180 days, performance was 198 days.

iii.Submissions received under the old user fee:

Submissions received prior to Apr 1, 2011 (by Filing Date) where a Review 1 decision was made in 2012/13.  These fees are not subject to the User Fees Act.